MINILAPAROSCOPIC APPENDECTOMY USING A PERCUTANEOUS SYSTEM: A FEASIBLE AND AESTHETICALLY FAVORABLE ALTERNATIVE FOR ACUTE APPENDICITIS gaboranolv@gmail.com

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MINILAPAROSCOPIC APPENDECTOMY USING A PERCUTANEOUS SYSTEM: A FEASIBLE AND AESTHETICALLY FAVORABLE ALTERNATIVE FOR ACUTE APPENDICITIS

4

Mexico

Oral or Poster

Minimally invasive laparoscopic techniques have evolved to reduce the number and size of incisions, decreasing hospital stay, analgesic use, and complications. Needlescopic/minilaparoscopic surgery uses instruments ≤3 mm. The MiniLap® System features a 2.4 mm percutaneous shaft with an integrated tip, eliminating the need for a trocar and reducing tissue trauma. This study evaluates the feasibility and outcomes of minilaparoscopic appendectomy (MLA) using this system for acute appendicitis (AA).

A prospective study was conducted between June 2023 and August 2024. Procedures employed a 10 mm trocar for the camera, a suprapubic 5 mm or 3 mm trocar (depending on minilaparoscopic-assisted vs. total MLA), and a percutaneous MiniLap handle for appendix traction via the right flank. All patients were discharged within 24-48 hours with mild analgesics and antibiotics. Thirty-day morbidity was recorded.

Thirty-two patients were included; 68.75% male, mean age 32.1 years, mean BMI 29.5 kg/m². Mean operative time was 38.5 minutes (range 21–115). Drainage was needed in 3 cases (1 grade 4, 2 grade 5 AA). Suprapubic trocar conversion (3mm to 5mm) occurred in 10 patients; 2 required percutaneous-to-conventional trocar conversion (both grade 5). Follow-up showed 87.5% reported mild/no pain; only 4 needed additional treatment. No complications occurred. Aesthetic satisfaction was high in 93.75%.

This novel minilaparoscopic technique using the percutaneous MiniLap system is safe, feasible, and yields excellent cosmetic and clinical outcomes. It represents a promising minimally invasive alternative for AA management.