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 ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 1  |  Page : 23-26

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


1 Department of Surgery, Hospital Militar de Área de Porto Alegre; Department of Surgery, Hospital de Clínicas, Federal University of Rio Grande do Sul State, Porto Alegre, Rio Grande do Sul, Brazil
2 Department of Surgery, Hospital Militar de Área de Porto Alegre, Rio Grande do Sul, Brazil
3 Department of Surgery, Institute of Education and Research, Hospital Moinhos de Vento de Porto Alegre, Rio Grande do Sul, Brazil
4 Department of Surgery, Federal University of Amazonas State, Manaus, Amazonas, Brazil
5 Department of Surgery, Hospital de Clínicas, Federal University of Rio Grande do Sul State, Porto Alegre, Rio Grande do Sul, Brazil

Correspondence Address:
José Gustavo Olijnyk
78 Praça Dom Feliciano St, 810 suite, Historic Center, Porto Alegre, Rio Grande do Sul-90020-160
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.124460

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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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