Implementation of single incision laparoscopic appendectomy (SIL-A) as standard procedure for appendectomy in a rural hospital setting

Summary BACKGROUND: Single incision laparoscopic surgery (SILS) is rapidly gaining popularity. The aim of this study was to evaluate the implementation of single incision laparoscopic appendectomy (SIL-A) as standard procedure for acute surgery and evaluate safety, feasibility, and learning curve for single incision surgery in a small rural hospital. METHODS: A retrospective analysis of the first 30 consecutive SIL-A for acute appendicitis was performed. Mean time of surgery in correlation to the level of laparoscopic surgical experience and the patients' BMI, the length of hospital stay, and the incidence of complications were analyzed. RESULTS: Six surgeons performed SILS appendectomy on 30 patients. Mean operative time was 50 min (range 35–150). No significant difference according to the level of the surgeons' experience in laparoscopic surgery was observed. Furthermore, no correlation between BMI and operative time was found (Pearson correlation 0.09, p = 0.636). Mean hospital stay was 4.3 days (range 3–10). Conversion to open appendectomy was performed in only one patient (3%). No wound infections were observed. CONCLUSION: SIL-A was implemented within a short period of six months, it proved safe and feasible for acute surgery within a short learning curve.