J Minim Invasive Surg 2018; 21(3): 124-129  
Solo Single-Incision Laparoscopic Appendectomy versus Conventional Single-Incision Laparoscopic Appendectomy:  A Retrospective, Single Center Study
Kyunglim Koo, M.D., Sang-Hoon Ahn, M.D.
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence to: Sang-Hoon Ahn
Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam 13620, Korea
Tel: +82-31-787-7106 Fax: +82-31-787-4078 E-mail: viscaria@gmail.com
ORCID: http://orcid.org/0000-0001-8827-3625
Received: May 11, 2018; Revised: May 29, 2018; Accepted: May 31, 2018; Published online: September 15, 2018.
© Journal of Minimally Invasive Surgery. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Single incision laparoscopic appendectomy (SILA) attempts to advance laparoscopic appendectomy with the aim of quicker recovery, less pain, a smaller scar, and better patient satisfaction, and it might offer better outcomes than conventional laparoscopic appendectomy. However, conventional SILA (C-SILA) is not widely practiced. C-SILA is associated with several ergonomic challenges when compared with standard multiport laparoscopy owing to the handling of straight instruments in parallel with a camera. The aim of this retrospective study was to review and compare the outcomes of SILA performed by residents in solo approach and a conventional non-solo approach in order to determine whether S-SILA can be performed effectively by residents.
Methods: Between March 2016 and February 2018, at SNUBH, 87 patients underwent SILA performed by residents, and of these patients, 36 underwent S-SILA and 51 underwent C-SILA.
Results: Patient characteristics and severities of appendicitis were different between the S-SILA and C-SILA groups. Although cases were more complicated in the S-SILA group, the surgical outcomes were similar between the S-SILA and C-SILA groups. These findings suggest that S-SILA can be a reasonable alternative to C-SILA for surgeons who can competently perform SILA.
Conclusion: The surgical outcomes were similar between S-SILA and C-SILA. Moreover, S-SILA could reduce the number of required personnel, resulting in a reduction in healthcare cost. S-SILA can be considered a reasonable alternative to C-SILA for surgeons who can competently perform SILA.
Keywords: Appendectomy, Laparoscope, Laparoscopic surgery, Solo surgery


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