Body image and cosmesis after laparoscopic or open appendectomy

Minimally invasive techniques, such as laparoscopic appendectomy (LA), are thought to produce better cosmetic results. The aim of this study was to evaluate the body image and cosmesis of patients after both LA and open appendectomy (OA).

Between August 2007 and June 2008, patients who underwent LA or OA with the diagnosis of acute appendicitis were invited to participate in the study by filling out the body image questionnaire. Patients with OA who had the Rockey-Davis incision and LA patients who had the operation by 3 trocars (10-mm infraumbilical, 5-mm suprapubic and additional 10 mm left lower quadrant), were included in the study.

A total of 38 patients (20 LA, 18 OA) participated in the study. The mean incision size for OA was 3.2 cm (range, 2 to 6 cm), and the mean scores from the body image questionnaire (both body image scale and cosmetic scale) were similar for both groups (P>0.05). No significant complications or changes in self-confidence (preoperative vs. postoperative) were observed in either group (P>0.05).

To our knowledge, there is no study in the literature that evaluates body image and cosmesis using objective methods for LA. Our results showed that LA has no advantage for body image and cosmesis over OA. Furthermore, prospective studies using different tools with a larger sample size are needed to rationalize the use of laparoscopy for appendectomy.