Single Incision Laparoscopic Surgery (SILS) Versus Laparoscopic Appendectomy - Full Text View

Purpose

This is a prospective trial of single incision versus standard 3-port laparoscopic appendectomy.

The hypothesis is that there may a difference in wound infection rates, operative time, doses of analgesics post-operatively, and patient/parent perception of scars.

Condition	Intervention
Appendicitis	Procedure: Single Incision Laparoscopic Appendectomy Procedure: 3 port laparoscopic appendectomy

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Single Incision Versus Standard Laparoscopic Appendectomy for Non-Perforated Appendicitis

Resource links provided by NLM:

MedlinePlus related topics: Appendicitis

U.S. FDA Resources

Further study details as provided by Children's Mercy Hospital Kansas City:

Primary Outcome Measures:

Post-operative infection [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

Doses of analgesic [ Time Frame: 3 days ] [ Designated as safety issue: No ]
Operative time [ Time Frame: 1 day ] [ Designated as safety issue: No ]
Cosmetic scores [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Length of Hospitalization [ Time Frame: 1 week ] [ Designated as safety issue: No ]
Surgeon perception of difficulty [ Time Frame: 1 day ] [ Designated as safety issue: No ]
Hospital/operative charges [ Time Frame: 1 week ] [ Designated as safety issue: No ]

Enrollment:	360
Study Start Date:	August 2009
Study Completion Date:	December 2011
Primary Completion Date:	November 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: SILS Single Incision Laparoscopic Surgery (SILS) where a single incision in the umbilicus is all that is used to remove the appendix. The specific methods (staple/tie/port use/etc) will vary depending on surgeon.	Procedure: Single Incision Laparoscopic Appendectomy A single incision through the umbilicus to remove the appendix Other Name: SILS
Active Comparator: 3 port Standard laparoscopic appendectomy with 3 ports and intracorporeal stapling.	Procedure: 3 port laparoscopic appendectomy Standard 3 port laparoscopic appendectomy with intracorporeal stapling Other Name: Laparoscopic Appendectomy

Detailed Description:

This is a prospective, randomized clinical trial involving patients who present to the hospital with non-perforated appendicitis. We will offer enrollment to several institutions provided they receive institutional approval.

There are likely several parameters that will show small differences between groups, and this study will precisely quantify them to allow for adequate consultation from surgeons to families dealing with acute appendicitis. One theoretical concern over the SILS approach is that the exposure of the appendix to the wound could increase the rate of infectious complications; therefore, this is the primary outcome variable. The documented rate of infectious complications at our institution in patients with non-perforated appendicitis is 0.6%. An unacceptable and clinically relevant rise to 5% may curtail enthusiasm for the new technique. Using a power of 0.9 with an α of 0.05, the sample size is 360 total patients or 180 in each arm.

After the procedure, both groups will be managed in the same manner per routine care. They will be discharged when tolerating a regular diet and their pain is well-controlled on oral pain medication. Cosmetic scores will be obtained at 6 weeks and 6 months.

Eligibility

Ages Eligible for Study:	1 Month to 18 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Children under 18 years
Non-perforated appendicitis

Exclusion Criteria:

Perforated appendicitis as identified as a hole in the appendix for fecalith in the abdomen

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00981136

Locations

United States, Missouri
Children's Mercy Hospital
Kansas City, Missouri, United States, 64108

Sponsors and Collaborators

Children's Mercy Hospital Kansas City

Investigators

Principal Investigator:

Shawn d St. Peter, MD

Children's Mercy Hospital Kansas City

More Information

No publications provided by Children's Mercy Hospital Kansas City

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

St Peter SD, Adibe OO, Iqbal CW, Fike FB, Sharp SW, Juang D, Lanning D, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW, Ostlie DJ. Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial. Ann Surg. 2012 Oct;256(4):581-5. doi: 10.1097/SLA.0b013e31826a91e5.

St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW 3rd, Ostlie DJ. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg. 2011 Oct;254(4):586-90.

Responsible Party:	Shawn St. Peter, MD, Children's Mercy Hospital Kansas City
ClinicalTrials.gov Identifier:	NCT00981136 History of Changes
Other Study ID Numbers:	09 07 133
Study First Received:	September 21, 2009
Last Updated:	February 13, 2013
Health Authority:	United States: Institutional Review Board

Keywords provided by Children's Mercy Hospital Kansas City:

Appendicitis
Appendectomy
Children
Laparoscopic
SILS

Additional relevant MeSH terms:

Appendicitis
Acute Disease
Gastroenteritis
Gastrointestinal Diseases
Digestive System Diseases

Cecal Diseases
Intestinal Diseases
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on May 19, 2013