scholarly journals TWO-PORT LAPAROSCOPIC APPENDECTOMY IS MORE BENEFECIAL THAN OPEN APPENDECTOMY IN EARLY ACUTE APPENDICITIS

2017 ◽  
Vol 52 (2) ◽  
pp. 131
Author(s):  
Vicky S Budipramana
Keyword(s):  
Acute Appendicitis ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
Operation Time ◽  
T Test ◽  
Small Incision ◽  
Post Operative Pain ◽  
Significant Difference

Open appendectomy has already commonly been performed to treat acute appendicitis, but the relatively more painful and longer incision scar becomes a cosmetical problem. Two port laparoscopic appendectomy can be performed safely, less painful and leaving only two small incision scars. The aim of the study was to evaluate the benefit of two-port laparoscopic appendectomy and that of with open appendectomy in the case of early acute appendicitis. An observational study was conducted from 2012 to 2014; to compare the operating time, post operative pain and wound infection in early acute appendicitis, performed with two-port laparoscopic appendectomy and with open appendectomy. The statistical analysis in this study uses t-test. There were 114 patients (73 men and 41 women) divided into two groups based on the choice made by the patients themselves. The number of samples performed with two-port laparoscopic appendectomy was 64 and that with open appendectomy was 46. Four patients were excluded from this study. In analysis using t-test, we found that the two-port laparoscopic appendectomy was more beneficial than open appendectomy. There was a significant difference between the two groups, the length of operation time was 37.22 minute in two-port laparoscopic appendectomy and 43.83 minute in open appendectomy (p=0.00), VAS pain score was 1.58 in two-port laparoscopic appendectomy and 2.30 in open appendectomy (p=0.00) and no post operative wound infection in both two groups. The conclusion is two-port laparoscopic appendectomy technique is faster and less painful and the same risk of wound infection than open appendectomy in early acute appendicitis.

scholarly journals Comparison of laparoscopic appendectomy versus open appendectomy in acute appendicitis in obese diabetic patients

2020 ◽  
Vol 10 (3) ◽  
pp. 145-148
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
World Health ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Post Operation

Background: Acute appendicitis (AC) is a common surgical problem requiring emergency hospitalization for urgent appendectomy. In case of diabetic patients, the incidence of developing acute appendicitis including its complications like abscess, gangrene and perforation is higher than non-diabetic. Day by day, laparoscopic appendectomy is having an improved outcome in non-diabetic and non-obese patients. The aim of this study was to compare the outcomes of laparoscopic appendectomy versus open appendectomy in acute appendicitis of obese diabetic patients. Methods: A comparative study was carried out in a tertiary care hospital in Dhaka City. Hospitalized obese diabetic patients with a diagnosis of acute appendicitis, who underwent appendectomy, were considered as study population. Obesity was defined as body mass index (BMI) greater than 30 kg/m2 according to World Health Organization and American Obesity Association guidelines. Patients were divided into two groups according to type of appendectomy; 50 patients by laparoscopic appendectomy as group LA and 50 patients by open appendectomy as group OA. Results: Most patients were obese I (30.0-34.9 kg/m2) in group LA and OA (92.0% and 86.0%, respectively, p<0.05). Uncontrolled diabetes mellitus was detected in most of the patients of both group LA (96.0%) and OA (98.0%). Mean operation time, mean duration of post-operation ileus, mean hospital stay and post-operation complications were less in group LA than group OA which is statistically significant (p< 0.05). No patient developed wound infection after laparoscopic appendectomy; whereas, 8.0% patients had wound infection in open appendectomy (p<0.05). Conclusion: In this study, laparoscopic appendectomy had good outcome over its open counterpart regarding shorter operating time, hospital stay, less wound infection, postoperative pain and time to return to usual activities. Birdem Med J 2020; 10(3): 145-148

scholarly journals Comparison of open versus laparoscopic appendectomy

2018 ◽  
Vol 6 (6) ◽  
pp. 2133
Author(s):  
P. S. Khatana ◽  
Jitendra Kumar ◽  
Manish Aggarwal
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Gall Stone ◽  
Operating Time ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Stone Disease ◽  
Significant Difference ◽  
Open Versus

Background: Although laparoscopic cholecystectomy has now considered the gold standard for the management of gall stone disease, laparoscopic appendectomy has not attained the same degree of popularity and acceptance. Aim of this study is to assess and compare the role of laparoscopic appendectomy with open appendectomy in acute appendicitis as well as in the patients planned for interval appendectomy.Methods: Total number of fifty cases over the age of 12 years were studied prospectively. Out of 50 number of total cases, 20 cases were those who have been operated laparoscopically while 30 cases were of open appendectomy group. The two groups were compared with respect to operative time, length of hospital stay, post-operative pain and nausea, complication rate and time to return to normal activity.Results: The mean age was 22.8±2(6.83) and 26.7±2(9.22) years in the laparoscopic and open groups respectively, with the range of 14 to 42 in the laparoscopic group and 13 to 50 years in the open group. The Average operating time was more in the laparoscopic appendectomy as compared to the time taken in performing open appendectomy. However, this was not statistically significant with p<0,05. Overall, there was no significant difference in the incidence of complications between open and laparoscopic groups.Conclusions: The laparoscopic appendectomy is safe, simple and efficient technique for treatment of acute appendicitis with result comparable to the open appendectomy, if not better.

scholarly journals Unligature method of laparoscopic appendectomy in children

2020 ◽  
Vol 10 (1) ◽  
pp. 53-58
Author(s):  
Vyacheslav G. Svarich ◽  
Evgeniy G. Perevozchikov ◽  
Ilya M. Kagantsov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operation Time ◽  
High Energy ◽  
Inflammatory Infiltration ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Digital Assessment

Aim. On the basis of the accumulated clinical material to show the possibility of a ligature-free method of laparoscopic appendectomy in children. Materials and methods. From 2000 to 2019, 2044 children with acute appendicitis were treated in the surgical department of the Republican childrens clinical hospital in Syktyvkar. Of these, 651 patients had an open appendectomy with treatment of the stump of the vermiform process by the submersible method, 1363 children had a laparoscopic appendectomy with ligature treatment of the stump of the process, and 32 patients had their first non-ligature laparoscopic appendectomy with the intersection of the vermiform process with the Ligasure device. Results. On average, surgery for ligature-free laparoscopic appendectomy lasted 7 3 minutes less than for laparoscopic appendectomy using the ligature method for treating the stump of the worm-like process. Experimentally, it was found that this method of appendectomy should not be used when the thickness of the worm-like process is more than 1.5 cm, with pronounced inflammatory infiltration of the caecum dome and perforation at the base of the process. With ligature-free appendectomy, the operation time was reduced. In the period from 1 to 6 months, there were no intra-abdominal postoperative complications associated with the new method of surgery. Conclusion. Ligar-free laparoscopic appendectomy in children using modern high-energy platforms with a digital assessment of the degree of tissue coagulation readiness made it possible to avoid intraoperative and postoperative complications, simplify the technique of its implementation, and reduce the time of surgery.

scholarly journals Transumblical Single Incision Two-Port Laparoscopic Assisted Appendectomy: Early Experience in Paediatric Patients

2009 ◽  
Vol 22 (2) ◽  
pp. 289-294
Author(s):  
MA Nowshad ◽  
A Mostaque ◽  
SMA Shahid ◽  
HK Emrul
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Open Appendectomy ◽  
Operation Time ◽  
Randomized Controlled ◽  
Safe Technique ◽  
Port System ◽  
Laparoscopic Assisted ◽  
Additional Port

Laparoscopic appendectomy considered as superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative port site complication as well as improving cosmesis and patients satisfaction. From January 2010, 32 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (9 males and 23 females) with an average age of 9.2 years. Transumblical single incision two-port laparoscopic assisted appendectomy was successfully completed in 31 patients. In one patient, another additional port required due to severe adhesion of the appendix. Mean operation time was 25.2 minutes (range, 17-38), and mean postoperative hospital stay was 1.Sdays (range 1-2). Postoperative complications (local pericaecal abscess) occurred in one case that was treated conservatively. Transumblical single incision two-port laparoscopic assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery. The true benefit of the technique should be assessed by randomized controlled trials.TAJ 2009; 22(1): 289-294

scholarly journals Comparison of open versus laparoscopic appendectomy in terms of post operative pain and operative duration.

2019 ◽  
Vol 26 (10) ◽  
pp. 1706-1711
Author(s):  
Saddaqat Hayat ◽  
Osman Riaz ◽  
Muhammad Usman ◽  
Muhammad Faisal Bilal Lodhi ◽  
Asrar Ahmad Khan
Keyword(s):  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
P Value ◽  
Operative Duration ◽  
Post Operative Pain ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Open Versus

Objectives: To measure the results of open appendectomy and laparoscopic appendectomy regarding mean postoperative pain and mean operative duration in the treatment of acute appendicitis. Study Design: Randomized clinical trial. Setting: Surgical unit Allied hospital Faisalabad. Period: June 2016 to December 2016. Material and Methods: 70 patients with appendicitis were included in the study through non-probability consecutive sampling. Patients with history of long standing pain, intake of analgesics (>3 times per week for >3 months) before surgery and patients in whom laparoscopic surgery was contraindicated were excluded. Patients were randomized in group A and group B. Open appendectomy was done in group A and laparoscopic appendectomy was carried in group B. Outcomes in terms of post-operative pain at visual analogue scale and operating time in minutes was measured. Results: Mean age was 28.50 years with standard deviation of 12.283. There were 32 (45.71%) patients were male and 38 (54.29%) patients were females. Post-Operative pain was 7.34±2.014 in group A and 3±1.94 in group B with p-value=0.0001. Operative time in group A was 42.33±4.25 minutes and group B had time of 34.48±3.5 minutes with p-value=0.0001. Conclusion: Laparoscopic appendectomy is superior to open appendectomy considering pain after surgery and time of surgery in patients with appendicitis.

Financial Impact of Surgical Technique in the Treatment of Acute Appendicitis in Children

2013 ◽  
Vol 79 (9) ◽  
pp. 857-860 ◽  
Author(s):  
Cristen Litz ◽  
Paul D. Danielson ◽  
Jay Gould ◽  
Nicole M. Chandler
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Open Appendectomy ◽  
Direct Costs ◽  
Financial Impact ◽  
Invasive Approach ◽  
Significant Difference ◽  
Supply Costs

Appendicitis is the most common emergent problem encountered by pediatric surgeons. Driven by improved cosmetic outcomes, many surgeons are offering pediatric patients single-incision laparoscopic appendectomy. We sought to investigate the financial impact of different surgical approaches to appendectomy. A retrospective study of patients with acute appendicitis undergoing appendectomy from February 2010 to September 2011 was conducted. Based on surgeon preference, patients underwent open appendectomy (OA), laparoscopic appendectomy (LA), or single-incision laparoscopic appendectomy (SILA). Demographic information, surgical outcomes, surgical supply costs, and total direct costs were recorded. A total of 465 patients underwent appendectomy during the study. The mean age of all patients was 11.2 years (range, 1 to 18 years). There were no conversions in the LA or SILA groups. There was a significant difference among surgical technique in regard to surgical supply costs (OA $159 vs LA $650 vs SILA $814, P < 0.01) and total direct costs (OA $2129 vs LA $2624 vs SILA $2991, P < 0.01). In our institution, both multiport laparoscopic and SILA carry higher costs when compared with OA, largely as a result of the cost of disposable instrumentation. Cost efficiency should be considered by surgeons when undertaking a minimally invasive approach to appendectomy.

scholarly journals Comparative study of single incision versus conventional three port laparoscopic appendectomy

2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Open Appendectomy ◽  
Single Incision Laparoscopic Surgery ◽  
Abdominal Incision ◽  
Significant Difference

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

scholarly journals Retrospective analysis of laparoscopic versus open appendectomy for the treatment of acute appendicitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4045
Author(s):  
Ritvik Resutra ◽  
Haroon Salaria ◽  
Rajive Gupta
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Routine Activity ◽  
Laparoscopic Technique ◽  
Time Duration ◽  
Jammu And Kashmir ◽  
Post Operative Pain ◽  
General Surgeons

Background: Acute appendicitis is one of the most commonly encountered emergency by the general surgeons and appendectomy is the most common surgery performed in the world. Although open appendectomy is preferred by many surgeons, yet the laparoscopic approach is gradually replacing open surgery for treatment of acute appendicitis.Methods: A total of 400 patients of acute appendicitis were operated, 200 by laparoscopic appendectomy and 200 by open method by a single surgeon at various private hospitals in Jammu (Jammu and Kashmir), India over a period of three years from July 2017 to July 2020. The two groups were compared with respect to operative time, duration of hospital stay, post-operative pain, complication rate and time taken to resume routine activity and cosmetic satisfaction of the patients.Results: Results were found to be better with the laparoscopic technique. There was significantly less pain in the postoperative period with faster recovery, early resumption to work, reduced postoperative complications and better cosmetic satisfaction of the patients operated by the laparoscopic appendectomy technique as compared to open surgery.Conclusions: Laparoscopic appendectomy is safe and feasible technique in expert hands, for treatment of acute appendicitis with results comparable to the open appendectomy, with no obvious increase in complications and is definitely a procedure of choice for the management of acute appendicitis.

scholarly journals Comparison of Outcome of Appendectomy: Laparoscopic versus Open Surgery in Combined Military Hospital, Savar

2021 ◽  
Vol 16 (2) ◽  
pp. 51-54
Author(s):  
Mohammad Faruq Iqbal ◽  
Arif Imtiyaz Chowdhury ◽  
Sharkar Rushdi Aziz
Keyword(s):  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Total Leukocyte Count ◽  
Military Hospital ◽  
Early Return ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Operative Complications ◽  
Duration Of Operation ◽  
Post Operative Complications

Introduction: Open appendectomy and laparoscopic appendectomy are two modalities in the treatment of appendicitis. Superiority of one over another is not clear. Objectives: To compare per-operative and post operative outcomes between open and laparoscopic appendectomy. Material and Methods: Prospective comparative study was conducted on patients with acute appendicitis who underwent open appendectomy (OA) (n=43) or laparoscopic appendectomy (LA) (n=59) from October 2018 to October 2019 in Combined Military Hospital (CMH), Savar. The two groups were compared in respect to patients' characteristics, duration of operation, operative findings, post operative pain, return of peristalsis, resume of oral feeding, post operative complications, return to activities and cosmesis. Statistical analysis was performed using SPSS 25.0. Continuous and categorical variables were analyzed using independent sample t test and chi-square test respectively and p <0.05 was considered statistically significant. Results: There was no statistical difference regarding patient characteristics between the two groups except total leukocyte count (TLC) and neutrophil count, both were higher in OA group (p<0.001). LA group was associated with less post operative pain (p<0.001), early resume of oral feed (OA-34.74±8.34 minutes vs LA-24.51±6.13 minutes; p<0.01), early return to light work (OA-4.26±1.3 days vs LA-2.53±0.7 days; p<0.001), heavy work (OA-66.93+19.38 days vs LA-37.36+10.02 days; p<0.001) and better cosmesis (highly satisfied in LA group 96.6% vs 30.2% in OA group). No significant difference was seen in duration of operation (50±13.72 and 53.31±7.69 minutes in OA and LA groups respectively; p>0.05). There was no significant difference in post operative complications (p>0.05). Conclusion: Laparoscopic appendectomy was found clearly superior to open appendectomy in terms of less post operative pain, early resume of oral feed, early return to light and heavy works and better cosmetic result. Both procedures are comparable in terms of duration of operation and post operative complications. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 51-54

Laparoscopic Appendectomy Provides Better Outcomes than Open Appendectomy in Elderly Patients

2011 ◽  
Vol 77 (4) ◽  
pp. 466-470 ◽  
Author(s):  
Shih-Chi Wu ◽  
Yu-Chun Wang ◽  
Chih-Yuan Fu ◽  
Ray-Jade Chen ◽  
Hung-Chang Huang ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Elderly Patients ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
Intraoperative Blood Loss ◽  
Postoperative Course ◽  
Ventilator Dependence ◽  
Hospital Days

The incidence of acute appendicitis in elderly patients is increasing due to prolonged life span. The associated morbidity and mortality related to perforation of acute appendicitis continue to present challenges to physicians. The role of laparoscopic appendectomy is still controversial. This study aimed to compare the postoperative outcomes of elderly patients who received either a laparoscopic or an open appendectomy. We retrospectively reviewed charts of patients with acute appendicitis between January 2005 and February 2009. Elderly patients who received laparoscopic or open appendectomies were enrolled. The demographics, preoperative condition, operating time, intraoperative blood loss, and postoperative course were analyzed. A total of 150 patients were enrolled in this study. On average, patients who received a laparoscopic appendectomy had fewer hospital days and lower rates of postoperative ventilator dependence than patients who received an open appendectomy. In the management of elderly patients with acute appendicitis, laparoscopic appendectomy provides better outcomes than open appendectomy.

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