A Cochrane review of 11 randomized controlled trials involving 1373 patients compared single-incision laparoscopic appendicectomy (SILA) with conventional multi-incision laparoscopy (CLA) for acute appendicitis. Pain scores at 24 hours were similar between groups, and complication rates—including visceral and vascular injury—did not differ significantly. SILA showed a small reduction in hospital stay and comparable recovery times, but had a higher likelihood of requiring conversion to CLA or the use of an additional port.
The analysis found that SILA was associated with better cosmetic satisfaction, reflecting a consistent advantage in patient-reported body image scores. Overall, the evidence—rated low to moderate certainty—indicates that SILA provides comparable short-term clinical outcomes to CLA, while offering improved aesthetic results but a slightly increased conversion risk. Further high-quality studies are needed due to variations in study design, blinding, and outcome measurement.
Keywords: single-incision laparoscopy, appendicitis surgery, SILA vs CLA, postoperative outcomes