Chen Y, Guo SG, Fu XA, Fan ZQ, Yuan JQ, Zhang XX, Liu H, Liu Z, Huang YS, Song L. Modified single-port laparoscopic appendectomy using needle-type grasping forceps vs conventional three-port laparoscopic appendectomy for acute uncomplicated appendicitis. World J Gastrointest Surg 2025; 17(4): 102607 [PMID: 40291869 DOI: 10.4240/wjgs.v17.i4.102607]
Corresponding Author of This Article
Yang Chen, Associate Professor, Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, No. 2-6, Chaoyang Street, Shuangta District, Chaoyang 122000, Liaoning Province, China. chenyangsurgeon@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Randomized Controlled Trial
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Chen Y, Guo SG, Fu XA, Fan ZQ, Yuan JQ, Zhang XX, Liu H, Liu Z, Huang YS, Song L. Modified single-port laparoscopic appendectomy using needle-type grasping forceps vs conventional three-port laparoscopic appendectomy for acute uncomplicated appendicitis. World J Gastrointest Surg 2025; 17(4): 102607 [PMID: 40291869 DOI: 10.4240/wjgs.v17.i4.102607]
World J Gastrointest Surg. Apr 27, 2025; 17(4): 102607 Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.102607
Modified single-port laparoscopic appendectomy using needle-type grasping forceps vs conventional three-port laparoscopic appendectomy for acute uncomplicated appendicitis
Lei Song, Yong-Shuai Huang, Zhu Liu, Huan Liu, Xiao-Xin Zhang, Jie-Qing Yuan, Zong-Qi Fan, Xin-Ao Fu, Shi-Gang Guo, Yang Chen
Yang Chen, Shi-Gang Guo, Zong-Qi Fan, Jie-Qing Yuan, Lei Song, Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, Chaoyang 122000, Liaoning Province, China
Xin-Ao Fu, Xiao-Xin Zhang, Huan Liu, Zhu Liu, Yong-Shuai Huang, Department of Gastrointestinal Surgery, Chaoyang Central Hospital, Postgraduate Training Base of China Medical University and Jinzhou Medical University, Chaoyang 122000, Liaoning Province, China
Co-corresponding authors: Yang Chen and Shi-Gang Guo.
Author contributions: Chen Y and Guo SG contributed to conception and design; Chen Y contributed to surgical protocol modified and performed, and manuscript writing; Fu XA, Fan ZQ, Zhang XX, Liu H, Liu Z, and Huang YS contributed to study materials provision, data collection and analysis; Yuan JQ and Song L contributed to patient care, follow up and literature search and selection; All authors reviewed and approved the final manuscript.
Supported by the Natural Science Foundation of Liaoning Province, No. 2023-MS-354; and the Science and Technology Project for Youth of Chaoyang Central Hospital, China Medical University, Liaoning Province, China.
Institutional review board statement: This study was approved by the Ethics Committee of Chaoyang Central Hospital, China Medical University (Approval No. 2024-03).
Clinical trial registration statement: This study has already undergone prospective registration for the clinical trial at https://www.chictr.org.cn/. The registration identification number is No. ChiCTR2400081025.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Dataset available from the corresponding author at chenyangsurgeon@qq.com.
Corresponding author: Yang Chen, Associate Professor, Department of Gastrointestinal Surgery, Chaoyang Central Hospital, China Medical University, No. 2-6, Chaoyang Street, Shuangta District, Chaoyang 122000, Liaoning Province, China. chenyangsurgeon@qq.com
Received: October 24, 2024 Revised: January 17, 2025 Accepted: February 8, 2025 Published online: April 27, 2025 Processing time: 157 Days and 1.7 Hours
Abstract
BACKGROUND
Single-port laparoscopic appendectomy is an advanced minimally invasive surgery that involves the use of upgraded instruments and equipment. We previously modified single-port laparoscopic appendectomy with needle-type grasping forceps (mSLAN) for patients with simple appendicitis, but the feasibility and safety of our modified procedure need further evaluation in a high-quality clinical study.
AIM
To compare the short-term clinical outcomes of mSLAN with those of conventional three-port laparoscopic appendectomy (CLA) for patients with acute uncomplicated appendicitis.
METHODS
This single-center, single-blind, prospective, randomized controlled trial included patients who underwent emergency laparoscopic appendectomy for acute uncomplicated appendicitis at our center between April 2024 and August 2024. Patients were randomly divided into the mSLAN group or the CLA group via computer-generated randomization. The primary endpoint was the 24-hour postoperative visual analog scale (VAS) score, and the secondary endpoints included the operative time, 24-hour postoperative inflammatory response biomarkers (including white blood cells, the neutrophil ratio, interleukin-6, and C-reactive protein), time to first postoperative exhaust, time to first out-of-bed activity, postoperative length of hospital stay, cost of hospitalization, and incidence of postoperative complications.
RESULTS
A total of 72 patients were enrolled and randomly divided into 2 groups: The mSLAN group (n = 36) and the CLA group (n = 36). The 24-hour VAS scores, 24-hour postoperative inflammatory response marker levels, first postoperative exhaust times, first out-of-bed activity times, postoperative lengths of hospital stay, operative times, or hospitalization costs did not significantly differ between the two groups. No postoperative complications, including incision infection or hernia, abdominal abscess or intestinal obstruction, were observed during the 1-month postoperative follow-up in either group.
CONCLUSION
Compared with the CLA protocol, the mSLAN protocol for acute uncomplicated appendicitis yielded comparable short-term clinical outcomes, with a similar operative time and better cosmetic outcomes, indicating its potential for clinical application and superiority for patients with high cosmetic requirements. Further research is needed to evaluate the long-term outcomes.
Core Tip: In this study, the short-term clinical outcomes of modified single-port laparoscopic appendectomy using needle-type grasping forceps (SLAN) were compared with those of conventional three-port laparoscopic appendectomy. Our results demonstrated the feasibility, safety, effectiveness, and clinical application potential of the modified SLAN protocol, which is an alternative minimally invasive surgical protocol for patients with acute uncomplicated appendicitis.
