Single-port laparoscopic appendectomy using a needle-type grasping forceps for selective adult patients with acute uncomplicated appendicitis

Effect of rapid rehabilitation surgical nursing on patients' gastrointestinal function recovery and sleep quality after laparoscopic appendectomy

BACKGROUND

Appendicitis is a common acute abdominal pain disorder. Laparoscopic appendectomy, a commonly used modality, is associated with less trauma and faster recovery than traditional open appendectomy. However, postoperative recovery remains an important issue that affects rehabilitation quality and surgical results.

AIM

To explore the effects of rapid rehabilitation and surgical nursing care on gastrointestinal function recovery and sleep quality among patients undergoing laparoscopic appendectomy.

METHODS

A total of 120 patients who underwent laparoscopic appendectomy at our hospital between January 2019 and March 2024 and for whom complete clinical data were available were selected. Patients were randomly assigned to two groups (n = 60 each) using the random number table method. The control group received routine nursing care, while the experimental group received rapid rehabilitation surgical nursing care; all patients continued to receive nursing care until discharge. The recovery of gastrointestinal function, length of hospital stay, complications, Pittsburgh sleep quality index, and nursing satisfaction were compared between groups.

RESULTS

Following the implementation of effective nursing measures, the times to bowel sound recovery, first exhaust, first defecation, and first feeding were notably shorter in the study vs control group (P < 0.05). Additionally, the duration of the first postoperative activity and the length of hospital stay were significantly shorter in the study vs control group (P < 0.05). Furthermore, the study group exhibited better sleep quality than the control group (P < 0.05). The postoperative complication rate was significantly lower and the nursing satisfaction rate significantly higher in the study vs control group (P < 0.05).

CONCLUSION

Rapid rehabilitation surgical nursing interventions provided to patients after laparoscopic appendectomy can accelerate their postoperative recovery, reduce the occurrence of complications, and improve their sleep quality and nursing satisfaction.

Modified technical protocol for single-port laparoscopic appendectomy using needle-type grasping forceps for acute simple appendicitis: A case report

BACKGROUND

Because of the mild inflammatory status in acute uncomplicated appendicitis, our team developed a novel technical protocol for single-port laparoscopic appendectomy using needle-type grasping forceps (SLAN) and achieved positive clinical outcomes. However, the intraoperative procedure lacked stability and fluency due to a series of problems highlighted by the small incision design of the protocol (only 1 cm long). Therefore, there is a growing clinical demand to further optimize the SLAN protocol.

CASE SUMMARY

An adult male patient was admitted for persistent right lower abdominal pain with preoperative computed tomography findings suggestive of appendicitis accompanied by localized peritonitis. A modified technical protocol for SLAN based on minimally invasive surgical principles was used, and the patient was confirmed to have acute simple appendicitis by postoperative pathological analysis. Postoperative recovery was uneventful, and no postoperative complications, such as incision infection or severe incision pain, were observed. The patient was discharged successfully on postoperative day 2.

CONCLUSION

The modified technical protocol of SLAN may be a new minimally invasive surgical alternative for patients with acute simple appendicitis.

A brief overview of single-port laparoscopic appendectomy as an optimal surgical procedure for patients with acute appendicitis: still a long way to go

Single-port laparoscopic appendectomy (SPLA) has become a good alternative to the traditional surgical treatment of acute appendicitis, due to its advantages of small incision, mild postoperative pain, short hospital stay, and good cosmetic effect. However, the further application of SPLA has been restricted by its relatively long operating time, high level of operating difficulty, and increased equipment and technical requirements. Clinical teams worldwide have attempted to improve and optimize SPLA technical protocols and equipment to maintain stable intraoperative pneumoperitoneal pressure, improve the 'triangle relationship' of operating angles, and develop new surgical procedures with less trauma and higher cost-effectiveness. Here, new SPLA techniques reported over the past decade are reviewed and compared, with the aim of providing new insights into technical improvements, equipment upgrades and clinical studies in the coming years.

Single-port laparoscopic appendectomy using a needle-type grasping forceps compared with conventional three-port laparoscopic appendectomy for patients with acute uncomplicated appendicitis: a single-center retrospective study

Objective

To compare the clinical outcomes between single-port laparoscopic appendectomy using a needle-type grasping forceps (SLAN) and conventional three-port laparoscopic appendectomy (CLA) for patients with uncomplicated appendicitis.

Methods

We retrospectively collected clinical data of patients with uncomplicated appendicitis who underwent SLAN or CLA from May 2019 to May 2021 in our center. The patients’ baseline characteristics, perioperative outcomes, and follow-up data were compared between the two groups. Additionally, baseline characteristics were compared with postoperative outcomes in the SLAN group.

Results

Ninety-six patients were enrolled (SLAN group, n = 32; CLA group, n = 64). The SLAN group had a shorter hospital stay, lower 24-hour postoperative visual analogue scale scores, shorter postoperative fasting time, lower frequency of antibiotic administration, and longer operative time than the CLA group. In the SLAN group, younger patients had a longer appendix and male patients had a thicker appendix; additionally, patients with an appendiceal diameter of 0.6 to 1.0 cm had a longer postoperative hospital stay and higher frequency of antibiotic administration.

Conclusions

Compared with CLA, SLAN may be less invasive, provide faster postoperative recovery, and result in better cosmesis for patients with uncomplicated appendicitis. Further research should be performed to evaluate the long-term outcomes.