Since its first description in 1983, laparoscopic appendectomy has gained acceptance as a treatment modality for acute appendicitis. Compared with open surgery, it has been proven to be less painful with better cosmesis.
When laparoscopic appendectomy is performed, the laparoscope is usually introduced into the abdominal cavity through a periumbilical incision and two additional laparoscopic instruments are inserted through 5-mm incisions and placed in a triangular fashion. This allows a completely intracorporeal appendectomy.
With the advent of minimal invasive surgery, the number of ports has been reduced to further improve cosmetic outcome. Single port laparoscopic appendectomy that requires only a single incision is becoming more popular. Various methods have been reported, from a single incision at the right iliac fossa to use of a single suprapubic incision that can be concealed in the pubic hair. A recent study concluded that the single port method is technically feasible even in children.
Transumbilical Single Port Laparoscopic Appendectomy
Among these methods, a single incision at the umbilicus is virtually scarless. There have been successful reports of the use of this transumbilical procedure in appendectomy, cholecystectomy, and other operations .
Transumbilical single port laparoscopic appendectomy (TUSPLA) is a form of single incision laparoscopic appendectomy that utilizes the transumbilical incision. Because the umbilicus has natural skin folds, has virtually no subcutaneous fat, and has a natural depression, TUSPLA can be performed easily even in obese patients.