Artigo

Two-port laparoscopic appendectomy as transition to laparoendoscopic single site surgery

José Gustavo Olijnyk, Guilherme Gonçalves Pretto, OMERO PEREIRA DA COSTA FILHO, Sidney Raimundo Silva Chalub, Leandro Totti Cavazzola, FERNANDO KOBOLDT MACHADO

Journal of Minimal Access Surgery, v. 10, n. 1, p. 23-26, 2014.

Motivo: Produção Colaborador HMV

Setor HMV: Quimioterapia

Área da saúde: Gastroenterologia

Resumo: BACKGROUND: According to the precepts of reduced surgical trauma and better cosmesis, an intermediate laparoscopic appendectomy technique between the conventional three-trocar procedure and Laparoendoscopic Single Site Surgery (LESS) was performed, based on literature review and experience of the surgical team. PATIENTS AND METHODS: Patients with early stage acute appendicitis and a favourable anatomical presentation were selected. The procedure was performed with two ports: A 10 mm trocar at the umbilicus site for laparoscope and a 5 mm one just above the pubic bone for grasper. The appendix was secured by external wire traction through a right iliac fossa puncture with 14-gauge intravenous catheter. RESULTS: From August 2009 to December 2012, we performed 42 cases; two required conversion to a conventional laparoscopic technique. There were no complications in the remaining, no wound infections and a mean operation time of 64.5 minutes. CONCLUSION: The use of two-port laparoscopic appendectomy can act as a LESS intermediate step procedure, without loss of instrumental triangulation and maintenance of appropriate counter-traction. This technique can be used as an alternative to the three-port laparoscopic procedure in patients with initial presentation of appendicitis and a favourable anatomical position.

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