The Effectiveness of Using Single Port Laparoscopic Appendectomy Versus Single Incision Multiport Laparoscopic Appendectomy

Abstract

Background : Acute appendicitis is the most frequent disease found in acute abdominal condition. It is generally recognized that laparoscopic surgery resulted in less pain than open surgery. There are two techniques of laparoscopic surgery, including single port and single incision multiport.Objective : This study aimed to compare pain score, morphine consumption and length of hospital stay between single port and single incision multiport techniques.Method : The randomized controlled trial was conducted on 120 acute appendicitis patients who had a laparoscopic appendectomy from 1st January to 31st December 2019. After obtaining ethical approval and written informed patient consent, 120 patients were randomly assigned into two groups, including single port group (n = 60) and single incision multiport group (n = 60). These two groups were compared for demographics, morphine consumption, pain score and length of hospital stay.Results : Regarding the personal information of patients in both groups were no differences in terms of age, gender, BMI, ASA classification, types of appendicitis, duration of symptoms, operative time and operative blood loss. The results also revealed no significant differences in post operative pain after 8, 12 and 24 hours. The average pain score of the single incision multiport group after the 8, 12 and 24 hours of operation were 5.27±2.36, 3.53±2.27 and 2.13±1.60, while mean pain score of the single port group after the 8, 12 and 24 hours of operation were 4.33±1.97, 3.17±2.04 and 1.91±1.51 with the p–value of 0.025, 0.338, 0.626 respectively. The mean length of hospital stay between single incision multiport and the single port group was 29±12.32 and 25±7.74 hours respectively with the p–value 0.038.Conclusion : The single incision multiport laparoscopic and single port are easy technique, economical and had no differences in post operative pain score. Even there was a minimal different in hospital length of stay between the two groups but it was not affects daily hospital cost or hospital bed occupied.