Dr. Nisha Thambuchetty, Dr. Rakesh Rai
Abstract: Open appendectomy is a time tested technique while laparoscopic appendectomy is newer concept. Small Incision Open Appendectomy was done via 2-3 cm incision at McBurneys point and Laproscopic Appendectomy was done via standard 3 port technique. Our Objective was to compare small incision open appendectomies with laparoscopic appendectomies. In the present study a total 60 patients with appendicitis were selected, of whom 30 underwent SIOA (small incision open appendectomy) and remaining 30 underwent LA (laparoscopic appendectomy). Both the technique were compared in terms of operative time, post-operative pain, analgesic requirement, post-operative length of stay, time to return to daily activities, complications, conversion rate, cost and cosmetic outcome. The results showed that SIOA is better than LA in terms of operative time (mean 25 vs. 44 minutes), time to return to daily activity (mean 4.8 vs. 6.2 days). SIOA and LA were comparable in terms of Post-operative pain (mean 5.3vs 5.9 at POD1), analgesics requirement (mean 5.96 vs. 5.93 doses), post-operative hospital stay (mean 2.9 vs. 3.5 days) and cosmetic effect. The cost was higher in LA group compared to SIOA. SIOA is the method of choice in thin and lean patients as LA offers no advantage over SIOA in this group while increasing costs.LA is the preferable method for obese patients. SIOA takes less time than LA.SIOA is comparable to LA in terms of post-operative pain, analgesics requirement, hospitals stay and return to daily activities. SIOA is more economic and cost-effective than LA. SIOA is cosmetically as good as LA.
Keywords: LA-laparoscopic appendectomy, SIOA-small incision open appendectomy, cosmetic results, cost effectiveness, duration of surgery