Two port laparoscopic assisted appendicectomy versus three port laparoscopic appendicectomy: A prospective study of 50 cases

Abstract

Background: To compare the operative time, intra-operative complications, hospital stay after surgery in patients undergoing appendicectomy with two port laparoscopic assisted appendicectomy versus three port appendicectomy considering all these factors. Patients and Methods: The is a prospective controlled randomized study performed on 50 patients admitted in Department of General Surgery, with diagnosis of acute appendicitis, recurrent appendicitis and those who were kept for interval. All patients with inflamed but non adhesive appendix were taken for study as cases irrespective of age and sex. They were randomly divided into two groups - group A and group B of 25 patients each. Patients with appendicular lump or those cases requiring conversion to open surgery were excluded from the study. Data were compared with cases of two port laparoscopic assisted appendicectomy versus three port appendicectomy. Results: In this study, 50 patients underwent appendicectomy, 16 patients were operated for acute appendicitis, 24 for recurrent appendicitis and on 10 patient's interval appendicectomy were performed. In 2-port laparoscopic assisted appendicectomy group 9 (36%) patients were operated for acute appendicitis, 11 (44%) for recurrent appendicitis and 5 (20%) as interval appendicectomy. In 3-port laparoscopic appendicectomy group 7 (28%) patients were operated for acute appendicitis, 13 (52%) for recurrent appendicitis and 5 (20%) as interval appendicectomy. None of the patients undergoing 2 - port laparoscopic assisted appendicectomy needed conversion to open appendicectomy. The mean duration of surgery was shorter in 2 port laparoscopic assisted appendicectomy 22.4 ± 5.61 minutes as compared to 3-port laparoscopic appendicectomy 43 ± 16.89 minutes ( P value-0.05). Mean length of hospital stay after surgery was 1.28 ± 0.293 days after 2 port laparoscopic assisted appendicectomy and 2.48 ± 0.927 days after 3-port laparoscopic appendicectomy. Conclusion: It is better in terms of operative time, post-operative complications and hospital stay, although there is not much difference between either intra-operative or post-operative complications. Nowadays, laparoscopic surgery/minimally invasive surgery is the best choice and it causes less postoperative pain and early recovery because of minimal trauma to the patients during surgery. In view of cost, conversion to open surgery and cosmetic results, two port laparoscopic appendicectomy is better. Two port can be used as an alternative to the three-port laparoscopic procedure with acute appendicitis and a favourable outcomes.