Single-incision laparoscopic appendectomy performed above the pubic symphysis - a new scarless approach.

The three-port method is commonly used for laparoscopic appendectomy. To obtain a better cosmetic result, we have selected the single-incision laparoscopic appendectomy to be performed above the pubic symphysis. We performed six single-incision laparoscopic appendectomies above the pubic symphysis. During each operation, a 2 cm transverse incision was made in the pubic hair area 3-4 cm above the pubic symphysis. A 5 mm trocar was then placed as an observation port with another two 5 mm trocars as main- and side-operating ports. The laparoscopic appendectomy was performed using this single-incision method. Six patients (five male and one female; body mass indexes of 18.07, 19.27, 21.67, 18.34, 26.83 and 22.46 kg/m(2), respectively) underwent successful single-incision laparoscopic appendectomy above the pubic symphysis. Operating times were recorded at 55, 58, 47, 51, 42 and 33 minutes, the corresponding post-operative anal ventilation times were 25, 24, 22, 18, 7 and 10 hours, while post-operative hospitalization periods stand at 3, 5, 2, 1, 3 and 2 days, respectively. No complications occurred during or post-operation. Our initial work shows that a single-incision laparoscopic appendectomy performed above the pubic symphysis is feasible and safe and yields excellent post-operative cosmetic results.