To Study the Comparison between Open Appendicectomy, Laparoscopic Appendicectomy and Lap Assisted Appendicectomy in Appendicitis Patients

Dr. chalwade Suhas Prafullchandra; Dr.Rupesh Gopal Thakare; Dr. Amit B. Aiwale

Volume : V, Issue : IV, April - 2016

To Study the Comparison between Open Appendicectomy, Laparoscopic Appendicectomy and Lap Assisted Appendicectomy in Appendicitis Patients

Dr. Chalwade Suhas Prafullchandra, Dr. Rupesh Gopal Thakare, Dr. Amit B. Aiwale

Abstract :

Background: Laparoscopic appendicectomy is yet to become acceptable as a procedure of choice for interval appendicectomy, unlike laparoscopic cholecystectomy which has been accepted as the gold standard of treatment of gall bladder stone disease. Open appendicectomy (OA) is usually performed through a single, small incision in right iliac fossa. In comparison, laparoscopic appendicectomy requires two to four multiple incisions for port entry, is likely to be more time consuming and requires special training. Laparoscopic appendicectomy can be performed either laparoscopically assisted (LAA) or totally laparoscopic (TLA). Objective: To study the intraoperative variability of different factors in open appendicectomy, laparoscopic assisted appendicectomy and total laparoscopic appendicectomy. Methods: Prospective observational study .Detailed record of each patient�s data was obtained from case papers. Written informed consent of procedures was checked from each patient for necessary surgical procedure appendicectomy Results: In all 60 patients were included in the study. Open appendicectomy (OA) group had 20 patients, laparoscopy assisted appendicectomy (LAA) group had 20 patients and total laparoscopic appendicectomy(TLA) group had 20 patients. Overall in about 80% cases the appendix could be found easily or after some manipulation. In approximately 20% cases, appendix was difficult to find and required further dissection for exposure of the appendix. almost 90% cases in each study group were completed as planned. The difference was not statistically significant. The need for change of plan was felt in 2cases of LAA. One case was required to be converted to open because the appendix could not be visualized due to excessive adhesions. The procedure was completed by open technique. In another case the length of the appendix was too short to be able to be delivered from the umbilical port. The plan was changed in 1 cases of LA. In one case the procedure had to be changed to open due to excessive adhesions. Overall, out of 40 cases of laparoscopic appendicectomy, 2 cases only had to be converted to open due to excessive adhesions, one each in LAA and TLA. Whereas, in 3 cases of open appendicectomy, the incision was inadequate and the incision had to be changed from muscle splitting to muscle cutting for adequate access. Conclusion: Laparoscopic surgery has lead to many changes in the management of surgical patients. . In our study also maximum numbers of patients were in the second and third decade of age group.