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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Innovation
  • Gastrointestinal Surgery

Background:

  • Low-impact laparoscopy (LIL) combines low-pressure insufflation and microlaparoscopy.
  • LIL has not been previously evaluated for acute appendicitis management.
  • This study assesses LIL feasibility and outcomes for appendectomy.

Purpose of the Study:

  • To evaluate the feasibility of a low-impact laparoscopy (LIL) protocol for acute appendicitis.
  • To compare postoperative pain, length of stay, and analgesic use between LIL and conventional laparoscopy.
  • To determine if LIL offers advantages over standard laparoscopic appendectomy.

Main Methods:

  • Prospective, double-blind, single-center study of 50 patients with uncomplicated acute appendicitis.
  • Patients were randomized to conventional laparoscopy (12 mmHg insufflation) or LIL (7 mmHg insufflation, microlaparoscopic instruments).
  • Outcomes measured included postoperative pain (VAS), length of stay, and in-hospital analgesic consumption.

Main Results:

  • No significant difference in complication rates between LIL and conventional groups (p = 0.81).
  • LIL group reported significantly lower postoperative pain at 2 hours (p = 0.019).
  • LIL protocol resulted in a statistically significant reduction in average length of stay (-0.77 days theoretical, -0.59 days actual; p < 0.001 and p = 0.03).

Conclusions:

  • Low-impact laparoscopy is a feasible approach for uncomplicated acute appendicitis.
  • LIL significantly reduces postoperative pain and shortens the average length of stay.
  • LIL represents a potentially beneficial alternative to conventional laparoscopic appendectomy.