Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Randomized controlled clinical trial. Our study is conducted on 30 patients with suspected acute appendicitis, half of patients underwent conventional laparoscopic appendectomy while the other half appendectomy was done by single incision laparoscopic surgery. Assessment of length of the operation, safety, efficacy, wound cosmetic outcome, complications, postoperative pain control, length of hospitalization and patient satisfaction. The SILA cases average operative time was 83.75 ± 17.98 minutes taking less time than that in MLA cases which was 112.5 ± 38.08 minutes. The average operative times for SILA were competitive. The use of conventional straight instruments was in all MLA cases. While in SILA cases the instruments was according to the single access device, as straight instruments could be used in some single access device as GelPoint, while others require the use of prebent or articulating instruments as X - CONE single access device. Gas leakage is a very frustrating problem encountered with X - cone. And it may occur in the GelPort system with prolonged procedures.The rate of conversion from SILA to MLA was 13.33% (2 cases) using 2 additional ports due to difficulty in delivery of the appendix. Conversion rate to open, intra - operative complications, length of hospital stay was nearly the same in both groups. Post operative complications were comparable and nearly equal in both groups except for incisional hernia as there is higher incidence in SILA patients

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