Single-port laparoscopic appendectomy for acute appendicitis during pregnancy

Abstract

Purpose: Acute appendicitis is the most common non-obstetric surgical problem in pregnant patients. As minimally invasive surgery has developed, minimizing surgical trauma and improving cosmetic outcomes have led to the development of single-port laparoscopic surgery (SPLS). The aim of this study was to assess the feasibility and safety of SPLS for acute appendicitis during pregnancy. Methods: Between September 2014 and May 2016, 12 pregnant patients diagnosed with acute appendicitis and having single-port laparoscopic appendectomy were included in the study. Results: The median gestational age at surgery was 16 weeks (6-30 weeks). All operations were completed safely and without vascular or visceral injury. Four patients (33.3%) required conversion to a reduced-port laparoscopic surgery with 3 patients (25%) having a 5mm port inserted because of perforated appendicitis with a drain placement, and 1 patient (8.3%) having a 2mm needle instrument insertion. Median operation time was 60 minutes (32–100 minutes), and a drainage tube was placed in 5 patients (41.7%). Median total length of incision was 2.0cm (1.2–2.5cm).The median time to soft diet initiation and length of stay in the hospital were 1 day (0–9 days) and 5 days (2–11 days), respectively. Two patients (8.0%) developed postoperative complications: 1 wound site bleeding and 2 surgical site infections. Onecase of abortion (8.3%) was noted on postoperative day 1 and 1 case of imperforate hymen was noted after delivery. Conclusion: SPLS appendectomy is feasible and safe for treating patients with acute appendicitis during pregnancy.