Evaluation of Single-Incision Multiport Laparoscopic Appendectomy (SIMPLA) Performed with Conventional Equipment

Single-incision laparoscopic surgery (SILS) has emerged as a new method of minimally invasive surgery. SILS appendectomy (SILA) is practiced worldwide, and some studies have proven its cosmetic benefit over conventional three-port laparoscopic appendectomy (CLA) but at higher expense. We evaluate the feasibility of single-incision multiport laparoscopic appendectomy (SIMPLA) with conventional laparoscopic equipment as the perfect cost-effective replacement of both conventional laparoscopic and standard SILA. Since June 2014 to January 2016, total 57 patients underwent SIMPLA. We did a retrospective observational study of the prospectively maintained data of patients who underwent SIMPLA. We have analyzed all the demographic and clinicopathological aspects and reviewed the literature to compare with SILA. The mean operating time was 42.71 +/- 5.75min to perform SIMPLA which is equivalent to SILA with a conversion rate 12.28%. There were minimal intra-operative blood loss, post-operative pain, other peri-operative complications, and length of hospital stay. The mean cosmesis score after SIMPLA was more than eight in post-operative period till the end of 6months. The cost to perform SIMPLA is much less than SILA in all the patients. The SIMPLA procedure, though it is taking a little higher time than usual, is giving a better cosmesis at a much lower cost which is making this procedure affordable and acceptable in developing countries.