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Conventional Laparoscopic Appendicectomy and Laparoscope-Assisted Appendicectomy: a Comparative Study.

Mayank Baid¹, Manoranjan Kar², Utpal De¹

¹Department of General Surgery, Medical College, 88 College Street, Kolkata, 700 073 West Bengal India.

The Indian Journal of Surgery

|January 6, 2016

Summary

Conventional three-port laparoscopic appendicectomy (LA) is superior to laparoscope-assisted appendicectomy (LAA). LA offers shorter surgery times, fewer complications, and quicker patient recovery, making it a preferred minimally invasive option.

Keywords:

Laparoscope-assisted appendicectomy (LAA)Laparoscopic appendicectomy (LA)

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Area of Science:

Surgical Innovation
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Laparoscopic appendicectomy is popular but faces criticism regarding technical difficulty, time, and cost.
Three-port laparoscopic appendicectomy (LA) and laparoscope-assisted appendicectomy (LAA) are minimally invasive alternatives to conventional appendicectomy.

Purpose of the Study:

To compare the efficacy and outcomes of conventional three-port laparoscopic appendicectomy (LA) versus laparoscope-assisted appendicectomy (LAA).

Main Methods:

A comparative study of 77 patients undergoing either LA (39 patients) or LAA (38 patients) between August 2010 and January 2012.
Data collected on surgical completion rates, operative time, complications (bleeding, conversion to open), postoperative pain, wound infections, and hospital stay.

Main Results:

LA had a 100% completion rate, while LAA had a 84.2% completion rate, with 5 LAA cases converted to LA and 1 to open appendicectomy.
LA demonstrated significantly shorter mean surgical duration (18.18 min vs. 24.39 min) compared to LAA.
LAA showed higher incidences of wound infections (6 vs. 2), severe postoperative pain (8 vs. 2), and longer hospital stays, with only 28.9% of LAA patients discharged by day 2 versus 79.5% for LA patients.

Conclusions:

Conventional three-port laparoscopic appendicectomy (LA) is a more effective and safer minimally invasive procedure than laparoscope-assisted appendicectomy (LAA).
LAA is associated with increased operative time, higher complication rates, more postoperative pain and wound infections, and prolonged hospital stays.
LA is recommended as the preferred minimally invasive approach for appendicectomy, particularly for patients with higher BMI.