Laparoscope-assisted appendectomy in adults: the two-trocar technique

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Gastrointestinal Surgery

Background:

• Open appendectomy remains the standard treatment for appendicitis.
• Laparoscopic appendectomy, particularly the "in" technique, is popular but technically demanding and costly.
• The safety and efficacy of the laparoscope-assisted two-trocar appendectomy were evaluated in adults.

Purpose of the Study:

• To assess the safety and efficacy of the laparoscope-assisted two-trocar appendectomy in adult patients.
• To evaluate this technique as a cost-effective and less technically demanding alternative to open and complete laparoscopic appendectomy.

Main Methods:

• A retrospective study of 129 adult patients undergoing laparoscope-assisted two-trocar appendectomy between July 2002 and December 2003.
• Procedures performed by experienced consultants and surgeons-in-training.
• Locally modified endoloop and reusable trocars were utilized to minimize costs.

Main Results:

• The two-trocar technique was successful in 78.3% of cases (101 patients).
• Conversion to open surgery was required in 4.6% of cases (6 patients).
• Mean operation time was 35 minutes, with a mean hospital stay of 2.8 days. Infection rate was 4.6% and no port hernias were reported.

Conclusions:

• Laparoscope-assisted two-trocar appendectomy is a safe and efficient alternative to open appendectomy.
• This technique is less costly and requires less technical expertise than the complete laparoscopic "in" method.
• It is recommended as a viable alternative for adult appendectomy procedures.