Appendicectomy for simple appendicitis: video-assisted or intracorporeal?

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Techniques

Background:

• Laparoscopic appendicectomy (LA) is a common procedure for simple appendicitis.
• Comparing video-assisted (extracorporeal) and entirely intracorporeal approaches is crucial for optimizing surgical practice.

Purpose of the Study:

• To compare the outcomes of video-assisted versus intracorporeal laparoscopic appendicectomy.
• To evaluate operating time, length of hospital stay, and complication rates for different LA techniques.

Main Methods:

• A retrospective review of 161 patients undergoing LA for simple appendicitis.
• Group A: 74 patients with video-assisted (extracorporeal) appendicectomy.
• Group B: 87 patients with entirely intracorporeal appendicectomy, utilizing various devices for mesoappendix dissection and base closure.

Main Results:

• No significant difference in overall outcome or complication rates between the two groups.
• Intracorporeal LA demonstrated a shorter operating time (29 minutes) compared to video-assisted (48 minutes).
• Hospital stay was shorter for intracorporeal LA (1 day) versus video-assisted (3 days), but disposable instrument costs were 3-6 times higher.

Conclusions:

• Laparoscopic appendicectomy for simple appendicitis can be safely performed using various techniques.
• The intracorporeal approach offers advantages in reduced operating time but incurs substantially higher costs for disposable instruments.