Suprapubic single-incision laparoscopic appendectomy (SSILA) has recently been studied by different authors, the targeted benefits were better cosmesis, less infection and possibly less hernia formation.

To evaluate the feasibility and benefits of SSILA by reviewing the most recent data published to date, and identifying the pros and cons of its use against an umbilical incision.

A systematic electronic search based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement was conducted, articles from 2010 to 2015 were reviewed. Only Adult population was included in the study. Pre-, intra- and postoperative variables were included in our study, such as operative duration, wound infection, cosmetic outcome and pain.

Four studies were included and round up a total of 129 patients. Incision size varied from 1.5 to 2.5 cm, procedure was completed in all studied candidates, mean operative time was 52.9 minutes, no intraoperative complications were recorded, wound infection occurred in 0.015% of cases, mean hospital stay 1 to 4.7 days, pain and cosmetic outcome were difficult to interpret due to the way, their evaluation was conducted. Suprapubic single-incision laparoscopic appendectomy appears to give a better operative view, follow-up duration 1 to 80 weeks. Most studies suffered from bias in all aspects.

Finding a different access site in acute appendicitis may decrease the rate of port-site complications, and hence the morbidity associated with it. The suprapubic incision is an appealing alternative, with lack of strong evidence to support it. The available evidence supports its use, but randomized controlled trials have to be conducted to determine its fait.

Al-Yaqout K, Alghurair A, Al-Tarrah H. The Future of Suprapubic Single-incision Laparoscopic Appendectomy. World J Lap Surg 2015;8(2):57-61.