Laparoscopic versus open appendectomy: which way to go?

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Minimally Invasive Procedures

Background:

• Acute appendicitis remains a common surgical emergency.
• Traditional open appendectomy is a well-established procedure.
• Laparoscopic techniques are increasingly adopted in general surgery.

Purpose of the Study:

• To compare the clinical outcomes of laparoscopic appendectomy versus open appendectomy.
• Evaluate differences in operative time, hospital stay, pain, complications, and cost.

Main Methods:

• Prospective study of 293 patients with acute appendicitis.
• Comparison between 165 patients undergoing open appendectomy and 128 undergoing laparoscopic appendectomy.
• Data collected on operative time, hospital stay, pain, complications, and cost.

Main Results:

• Laparoscopic appendectomy showed a shorter hospital stay (2.2 vs 3.1 days) and lower wound infection rates (5.3% vs 12.8%).
• Higher incidence of intra-abdominal abscesses in complicated cases after laparoscopic appendectomy (5.3% vs 2.1%).
• Operative time, analgesia needs, and patient characteristics were similar; laparoscopic surgery was more expensive.

Conclusions:

• Laparoscopic appendectomy is a safe and effective alternative to open surgery.
• Successful implementation requires adequate surgical expertise and equipment.
• Careful patient selection is important, especially in complicated appendicitis.