Appendectomy is one of the most common operations in abdominal surgery. Most appendectomies are simple, and a few are complicated because of the condition. The transumbilical single port laparoscopic technique became the hotspot in the field of surgery had a history of 20 years, but it is popularized slowly, mainly because there is limited vision and adverse factors such as operating devices interfere with each other when the lens and the two operating instruments work together through the same small incision. Different laparoscopic single-hole devices have different characteristics in terms of operational flexibilit Since 2011. The author has developed a laparoscopic single-port device (Iconport), and tried it on more than 200 cases of tranumbilical single-port laparoscopic appendectomy. The data of this group are from the surgical practice of the same surgeon using the same device and similar methods after the learning period. In the past, most surgeons believed that the greatest benefit of single-hole surgery lay in the aesthetic incision, so the incision must be very small. The author thinks there is some prejudice in this view. In this study, the author used three cloth pliers to locate and pull the skin at the edge of the umbilicus foramen, and the scalpel was inserted subcutaneously to cut the skin, so that the incision line ran strictly on the skin fold around half of the umbilicus foramen(Figure 2), to ensure the aesthetic appearance of the surgical mark(Figure 4). In the author's opinion, the aesthetic degree of the incision mainly depends on the radius distance between the incision line and the central point of the umbilical foramen. The closer the u-shaped incision is to the umbilical hole, the more satisfied it is to hide the surgical mark. The length of the incision is not the main factor affecting the aesthetic quality. The aesthetic degree of incision is directly related to the original shape of umbilical foramen. The design of the umbilical incision is a u-shaped incision around the umbilicus, so that the incision mark can be "hidden in the umbilical foramen " as far as possible. In some patients, the umbilical foramen is small and the skin surrounding the umbilical foramen is flat and lacks the normal skin folds, which cannot be completely hidden by any kind of incision. The u-shaped incision made by the method described in the paper can make the postoperative incision mark "look like umbilical foramen ". In other words, the morphology of umbilical foramen after surgery may be slightly different from that of the patient before surgery, but the appearance of the surgical mark of u-shaped skin incision looks like the common morphology of umbilical foramen, thus hiding the surgical mark objectively. The overemphasis on smaller incisions makes all single-port laparoscopic procedures very difficult and artificially increases the risk of intraoperative procedures causing accidents. The author suggests that the Iconport device should be used for single-port laparoscopic surgery with an incision of 2.5cm in adults. In the process of single-hole laparoscopic surgery with a small incision of 2.5cm, two laparoscopic operating instruments can form an effective operational triangle. There are 4 operation holes on the operation panel of Iconport. The lens enters the surgical field through the middle hole. The center distance of the operating holes on both sides of the lens is 4cm and which of the two operating holes in the adjacent position is 3cm. When the ends of the two instruments reach the same point in the abdominal cavity, the width of the instruments passing through the incision should be less than 2.5cm. Therefore, the 2.5cm incision can ensure the flexible operation by surgical instruments. Using different operating holes in pairs in operation can solve the problem of unsatisfactory visual field exposure in the single operating hole scheme. Although an incision of 2.5cm to 3cm in the right lower quadrant of the abdomen can be used for some simple appendectomy, the same 2.5cm incision around the umbilical border allows most appendectomies to be done with laparoscopic instruments, Moreover, the incision infection rate is low, the incision pain is light, and the incision mark is hidden in the umbilical foramen, which are the advantages of transumbilical single-port laparoscopic surgery[13]. In this study, such small sum of operations (6 cases) were completed by adding auxiliary operation holes or switching to open operation. The main reasons are as follows: 1. Unclear anatomical relationship caused by inflammatory dense adhesion. 2. Increased brittleness of appendix, with the risk of rupture near the root of appendix. 3. Accidental bleeding and attempted hemostatic measures are not effective. 4. Misdiagnosis and accidental injury. In fact, in the process of "three-hole" laparoscopic surgery, most surgeons need to add auxiliary operating holes to change to "four-hole" or change to open surgery in these conditions. According to the author's experience, single-port laparoscopic appendectomy can be carried out smoothly if the appendix can be effectively pulled after preliminary separation and the appendix can withstand a certain pull strength. When severe appendicitis occurs and there is risk of rupture caused by traction, careful evaluation should be made to determine whether the operation can be successfully completed through gentle operation. Otherwise, auxiliary operation holes should be added in time. Once the appendix ruptures from the root, it was difficult to complete the operation through a single hole in most cases. When the position of retroperitoneum appendix was difficult to be exposed, the surgical field can be exposed with the help of small gauze strips and turnable laparoscopic surgical instruments. After turning the head of the instruments, intestines and mesentery can be effectively blocked to the medial side like the effect of retractor. In this study, the infection rate of incision was 4.8% (6/125). All the 5 incisions with early infection had the problem of inadequate irrigation before incision closure. The root reason why incision infection can be effectively controlled is that the removal of the operating panel during the operation and the removal of the specimen through the incision sealing sleeve completely avoid the risk of contact between the specimen and the incision. Compared with conventional three-hole laparoscopic surgery, the literature has different conclusions on whether the incision pain is increased or reduced[8-16]. VAS score of postoperative incision pain in this group was 1-3 points, and no patients needed to use analgesic drugs to treat incision pain. The author thinks the reason for the inscision mildly pain was related by the different incision methods. The data of this study were about the incision around the edge of umbilical foramen. The incision was relatively large, and the suture needle can enter into the incision to firmly suture the aponeurotic layer tissue. Because the umbilical incision surgery avoided the injury to the bilateral rectus abdominis, the postoperative events were less likely to cause incision pain due to the activities of daily life. The author believes that the probability of secondary incisional hernia of umbilical incision after umbilical single-hole laparoscopic surgery is decreased rather than increased, which is compared with that of three-hole laparoscopic puncture, because the large incision is conducive to suture tightly. In laparoscopic surgery, there is a common unreasonable phenomenon of "small hole operation and large hole specimen removed ", especially in laparoscopic gastrointestinal tumor surgery. Since the whole specimen needs to be removed, an incision of at least 3-4cm is necessary before the specimen can be removed from the body. The existing plan was to complete the operation with laparoscope first, then enlarged one of the operating holes or make another small incision to remove specimens, and then reconstruct pneumoperitoneum to complete the subsequent operation process. In these cases, the incision needed for remove the specimens was not fully utilized in the whole operation process. The medical silicone seal sleeve for Iconport single-hole device to enter the incision has different specifications, including 1cm, 2cm, 3cm ,5cm etc, depending on the incision diameter. The device is suitable for clinicians to choose according to the operation difficulty of specific surgery and whether there is a need to remove samples. 2cm size is commonly used for general appendix surgery, while 1cm size is optional for children. Obviously, the larger the incision is, the less difficulty the operation will be and the smaller the incision is, the more pretty the appearance of the operation mark is. For laparoscopic surgery with an incision is larger than 3cm required for specimen remove, the umbilical incision should be made according to the requirements of specimen which should remove at the beginning of the operation, so as to achieve the goal of reducing and narrowing the laparoscopic puncture hole and to give consideration to the operating habits of surgeons without increasing the difficulty and risk of surgery.