Letter to the editor RE: "Conservative management of 11 weeks old cervical ectopic pregnancy with transvaginal ultrasound-guided combined methotrexate injection: Case report and literature review"

INTRODUCTION: Single -port laparoscopy has been used in any areas of surgery, including appendectomy, to reduce the operative stress and enhance postoperative recovery procedure. This paper introduces our attempt to perform single -port laparoscopic appendectomy using conventional laparoscoopic instru- ments and a needle -type grasping forceps (SLAN), which has dominant advantage in cosmetic appearance. METHODS: We report six pediatric patients who underwent SLAN for uncomplicated appendicitis from April to November 2019. SLAN was performed transumbilically, while conventional laparoscopic instru- ments and needle -type grasping forceps were both used. After routine intracorporeal appendectomy was completed, the pathological appendix was extracted through the single -port site, while a 10 mm trocar was used to avoid incision infectious. Clinical data and postoperative follow-up data were collected and analyzed to evaluate the feasibility, safety, and clinical outcomes of this novel technique. RESULTS: SLAN was successfully performed in all six pediatric patients. The median operative time, first exhaust time after surgery, pain score of postoperative day 1, and postoperative hospital stay were 69 (range, 50 -85) min, 1.33 (range, 1-2) d, 0.83 (range, 0-3) score, 1.5 (range, 1-2) d, respectively. Nei- ther intraoperative nor postoperative complications were noted, while no incision infectious, adhesive intestinal obstruction, and abdominal abscess were observed with 2-9 months follow up. DISCUSSION: Though there are many methods to perform single -port laparoscopic appendectomy, the use of needle grasping forceps in laparoscopic appendectomy has been confirmed a new choice for uncomplicated appendicitis in children. CONCLUSION: SLAN is a feasible and safe technique to treat acute uncomplicated appendicitis in children. To be emphasized, surgeons must strictly grasp the indications for this surgery. (c) 2020 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).