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

Figure 1  Preoperative abdominal computed tomography scan suggested appendicitis with localized peritonitis.

Figure 2 Intraoperative arrangement. A: Intraoperative device placement: A 1 cm trocar (for primary operation) and a 5 mm trocar (for laparoscopic observation) were inserted into the abdominal cavity via the umbilical incision, and a needle-type grasping forceps (Approval No. Zsyjx 20140056; Hangzhou Kangji Medical Instrument Co., Ltd., Hangzhou, China) were inserted at the McBurney point; B: Surgeon’s standing position: The laparoscopic display screen was on the right side of the patient, while the surgeon stood down to the left and the assistant at the upper right; C: Intraoperative laparoscopic images: The appendix was located in the anterior position of the cecum, and the surface was hyperemic and edematous; needle-type forceps were inserted into the abdominal cavity to assist with traction of the appendix's mesentery; sterile gauze was inserted into the right iliac fossa to clear bleeding and exudation; longer Ham-o-lock clips were placed to shut the root and distal part of the appendix; and an ultrasonic scalpel was applied to cut the appendix accompanying its mesentery.

Figure 3 Postoperative outcomes. A: Postoperative day 2 incision appearance; B: Postoperative pathologic outcome (200 × HE staining).