Single-port laparoscopic appendectomy for acute appendicitis during pregnancy

Abstract

Aim of study: Acute appendicitis is the most common non-obstetric surgical problem in pregnant patients. As minimally invasive surgery has developed, minimising 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.

Patients and 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 5 mm port inserted because of perforated appendicitis with drain placement, and 1 patient (8.3%) having a 2-mm needle instrument insertion. Median operation time was 60 min (32-100 min), and a drainage tube was placed in 5 patients (41.7%). Median total length of incision was 2 cm (1.2-2.5 cm). 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 post-operative complications: One wound site bleeding and two surgical site infections. One case of abortion (8.3%) was noted on the post-operative day 1 and one case of imperforate hymen was noted after delivery.

Conclusions: SPLS appendectomy is feasible and safe for treating patients with acute appendicitis during pregnancy.