Comparison of needlescopic appendectomy versus conventional laparoscopic appendectomy: a randomized controlled trial

Area of Science:

• Minimally Invasive Surgery
• Surgical Outcomes Research
• Gastrointestinal Surgery

Background:

• Laparoscopic appendectomy generally improves recovery over open procedures.
• Needlescopic appendectomy (NA) utilizes smaller instruments (< or = 3 mm) than conventional laparoscopic appendectomy (CLA) (> or = 5 mm).

Purpose of the Study:

• To compare the outcomes of needlescopic appendectomy (NA) versus conventional laparoscopic appendectomy (CLA) for acute appendicitis.
• To evaluate differences in postoperative recovery, complications, and scar length between NA and CLA.

Main Methods:

• A randomized trial involving 363 patients with acute appendicitis.
• Patients were randomized to either NA or CLA with standardized perioperative management.
• Outcomes assessed included operation time, conversion rate, pain, recovery parameters, complications, and scar length.

Main Results:

• Both NA and CLA demonstrated high diagnostic accuracy.
• NA resulted in significantly longer operation times and higher conversion rates compared to CLA.
• The NA group achieved significantly shorter final scar lengths, but other recovery parameters, including hospital stay and complication rates, showed no statistical difference.

Conclusions:

• Needlescopic appendectomy (NA) leads to longer operative times and increased conversion rates compared to conventional laparoscopic appendectomy (CLA).
• While NA offers cosmetic benefits with smaller scars, it does not provide significant short-term clinical advantages in recovery or complication rates.
• Based on these findings, NA cannot be routinely recommended for the management of acute appendicitis.