Comparative study of laparoscopic appendicectomy versus open appendicectomy in appenidicitis patients

Abstract

Laparoscopy in patients with a clinical suspicion of acute appendicitis has not gained wide acceptance and its use remails controversial. Laparoscopic appendicectomy has been shown to be both feasible and safe in randomized comparisons with open appendicectomy. In addition to improved diagnostic accuracy, laparoscopic appendicectomy confers advantages in terms of fewer wound infection,less pain faster recovery and earlier return to work. However laparoscopic appendicectomy is more time consuming is associated with increased hospital costs. It has been argued that the advantages of laparoscopic appendicectomy achieved by experienced laparoscopic surgeons are marginal compared with open appendicectomy, which can also be performed by surgeons in training through a short, cosmetically acceptable incision with minimal complications and a short hospital stay. Although the most people have concluded that the laparoscopic technique is as least good as open technique, there has been considerable controversy as whether laparoscopy is superior. Aims and Objectives: In this study the different aspects, e.g. intra operative diagnosis, operating time and other advantages and complications of laparoscopic appendicectomy were observed and compared to that of open appendicectomy in our setup.Materials and Methods:The present prospective study has been carried out in the Department of General Surgery, Rajendra Institute Of Medical Sciences, Ranchi from September 2020 to August 2021. 50 patients presented in the hospital with the clinical features of acute appendicitis were selected for the study. These patients were divided into two groups in a random way, 25 patients underwent open surgery and 25 patients underwent laparoscopic surgery.Conclusion :Laparoscopic appendicectomy has the advantage to directly visualize the entire peritoneal cavity and can deal with other associated pathologies. Besides good cosmesis it has the disadvantage of being expensive and having increasing operating time. Complicated cases may have to converted to open procedure. Open appendicectomy is not only cheap and faster but also has good cosmesis in uncomplicated cases. Even the complicated cases can be managed better and has lower incidence of residual intra abdominal abscess. So to conclude open appendicectomy is safe, cost effective and remains the procedure of choice in our set up.