[Appendectomy with a single trocar through the umbilicus: results of our series and a cost approximation]

Abstract

In our department we perform the appendectomy through a single periumbilical incision. A double channel laparoscope aids to locate and exteriorize the appendix.

Objective: We studied this practice to determine if this technique makes it possible to make use of the advantages of laparoscopic surgery and of open surgery, decreasing costs without increasing the rate of complications.

Materials and methods: Clinical prospective paper. The study group was made up of transumbilical appendectomies (TA) for acute, uncomplicated appendicitis carried out in 2004 and 2005. The control group consisted of a group of open appendectomies (OA) performed for acute, uncomplicated appendicitis in our department in 2002 and 2003 (from a previous study).

Results: Both study groups were comparable. We performed a total of 162 TA due to uncomplicated appendicitis. The mean hospital stay was 2.84 days (versus 4.83 days with OA) (significant difference). Infectious complications presented in 4.29% (versus 1.75% in the OA group) (this difference was not significant). Postoperative pain and need for analgesia were less in the TA group than in the OA (difference did not reach significance).

Conclusions: Described technique is easily performed. The savings resulting from the transumbilical technique represent some 90,561.97 euros / year compared with the cost that laparoscopic appendectomy would incur, and some 42,232.37 euros/ year versus traditional, open surgery. Postoperative complications didn't increase significantly if compared with open appendectomy.