Yu HB, Jin YB. Transumbilical three-port vs conventional laparoscopic appendectomy: A single-center retrospective comparative study. World J Gastrointest Surg 2026; 18(8): 119249 [DOI: 10.4240/wjgs.119249]
Corresponding Author of This Article
Hai-Bo Yu, MD, Associate Chief Physician, Department of General Surgery, Shengzhou People’s Hospital (Shengzhou Branch of the First Affiliated Hospital of Zhejiang University School of Medicine, the Shengzhou Hospital of Shaoxing University), No. 666 Dangui Road, Sanjiang Street, Shengzhou 312400, Zhejiang Province, China. 543618046@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2026; 18(8): 119249 Published online Aug 27, 2026. doi: 10.4240/wjgs.119249
Transumbilical three-port vs conventional laparoscopic appendectomy: A single-center retrospective comparative study
Hai-Bo Yu, Yi-Bing Jin
Hai-Bo Yu, Yi-Bing Jin, Department of General Surgery, Shengzhou People’s Hospital (Shengzhou Branch of the First Affiliated Hospital of Zhejiang University School of Medicine, the Shengzhou Hospital of Shaoxing University), Shengzhou 312400, Zhejiang Province, China
Author contributions: Yu HB designed the study, performed data collection and analysis, and drafted the manuscript; Jin YB contributed to study design, supervised the research, and revised the manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of Shengzhou People’s Hospital, No. SZRY-REB-2026(011).
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are not publicly available due to privacy reasons but are available from the corresponding author upon request.
Corresponding author: Hai-Bo Yu, MD, Associate Chief Physician, Department of General Surgery, Shengzhou People’s Hospital (Shengzhou Branch of the First Affiliated Hospital of Zhejiang University School of Medicine, the Shengzhou Hospital of Shaoxing University), No. 666 Dangui Road, Sanjiang Street, Shengzhou 312400, Zhejiang Province, China. 543618046@qq.com
Received: January 23, 2026 Revised: March 11, 2026 Accepted: April 24, 2026 Published online: August 27, 2026 Processing time: 206 Days and 8.7 Hours
Abstract
BACKGROUND
Laparoscopic appendectomy (LA) is a widely accepted treatment for acute appendicitis. Conventional three-port techniques require additional abdominal incisions that may affect cosmetic outcomes, whereas transumbilical approaches may improve scar concealment. However, direct comparative evidence remains limited.
AIM
To evaluate the safety and perioperative outcomes of transumbilical three-port LA compared with conventional LA.
METHODS
This retrospective single-center comparative study included 77 patients who underwent LA between June 2022 and October 2023 at a tertiary hospital. Patients were treated with either a transumbilical three-port approach (n = 51) or conventional LA (n = 26). Baseline characteristics, operative outcomes, postoperative pain scores, complications, hospitalization costs, and cosmetic outcomes were compared. Logistic regression analysis was performed to identify predictors of prolonged hospitalization (> 3 days).
RESULTS
All procedures were completed laparoscopically without conversion or major complications. Operative time, postoperative complications, and early pain scores were comparable between groups (all P > 0.05), with a trend toward lower pain in the cosmetic group. Total hospitalization costs were higher in the cosmetic group (P < 0.05), which may partly reflect temporal variations in consumable and medication pricing. In univariate analysis, elevated preoperative white blood cell (WBC) count and C-reactive protein levels were associated with prolonged hospitalization (P < 0.05). After adjustment, preoperative WBC remained the only independent predictor (adjusted odds ratio = 11.55, 95% confidence interval: 2.28-80.44).
CONCLUSION
Transumbilical three-port LA using conventional instruments appears safe and feasible and may improve cosmetic outcomes without increasing operative risk or hospital stay. Preoperative WBC may predict hospitalization duration.
Core Tip: This study evaluates the feasibility and clinical value of transumbilical three-port laparoscopic appendectomy (LA) using conventional instruments. By restoring a triangular operating configuration through the umbilicus, this technique avoids the technical limitations of single-incision surgery while achieving superior cosmetic outcomes. Perioperative safety, postoperative pain, and complication rates were comparable to conventional multiport LA. In addition, factors associated with prolonged hospitalization were explored. These findings suggest that transumbilical three-port LA is a safe, cosmetically advantageous, and practical alternative in selected patients.
