To investigate the safety, feasibility and short-term efficacy of transvaginal appendectomy with traditional single-port laparoscopic instruments, and to evaluate its clinical application value.

Thirty female patients with acute appendicitis were prospectively collected from November 2019 to May 2021 at the Department of General Surgery, No.988 Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army. Fifteen patients underwent transvaginal appendectomy with the single-port laparoscopic instrument as the observation group. Another 15 patients underwent conventional three-port laparoscopic appendectomy as the control. The operation time, bleeding volume, postoperative pain score, postoperativ exhaust time, postoperative complications, incision satisfaction, hospitalization time, hospitalization expenses and postoperative serum inflammation indexes between the two groups were compared. The sexual function (before surgery and 4th, 8th, 12th months after surgery) was observed in the observation group.

All 30 operations were completed without transfer. There were no significant differences in the bleeding volume (t=-0.410, P=0.685), the CRP at 1st (t=-1.720, P=0.096), 3rd (t=-0.877, P=0.388) days and the IL-6 at 1st (t=-1.797, P=0.083), 3rd (t=-0.602, P=0.552) days after the operation. The observation group was superior to the control group in terms of postoperative pain score (1st day: t=-3.191, P=0.003; 2nd day: t=-2.084, P=0.046), first exhaust time(t=-2.259, P=0.032) and hospitalization time (t=-3.497, P=0.002). But the observation group was higher than the control group in the operation time (t=6.231, P<0.001) and the hospitalization expense (t=3.276, P=0.003). Two complications occurred in the observation group and one complication in the control group, there were no statistically significant differences between the two groups (χ²=0.370, P=1.000). The incision satisfaction in the both groups was 93.33% at one month after the operation. The mean FSFI of preoperation and 4th, 8th, and 12th months after operation were (25.64±1.60), (25.62±1.21), (26.09±1.39), (26.63±1.30), there was no statistically significant differences between the groups (F=1.759, P=0.166).

Transvaginal appendectomy with traditional single-port laparoscopic instruments is safe and feasible, has no effect on sexual function. The short-term effect is satisfactory, and the scar-free cosmetic effect is definite. And it is an optional operation for married multipara with higher cosmetic requirements.