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Background: Open appendisectomy (OA) had been the procedure of choice for acute appendisectomy for a century since Mc Burney introduced in 1884. Laprascopic appendisectomy (LA) didn’t gain popularity and many studies had been conducted to see the superiority of one over the other. Recent meta-analysis studies, found overall benefits in favour of LA. So, we have done comparative study with the aim to compare the benefits of LA over OA.Methods: Total of 90 appendisectomies was done, 45 each in OA and LA group and compared over a period of 1-year from October 2016 to October 2017 in Indira Gandhi Medical College and RI, Pondicherry. Outcome parameters were compared between the 2-groups in relation to operative time, analgesia used, length of post-operative hospital stay, return to work, resumption of a regular diet, post-operative scar and post-operative complications.Results: Mean age of LA was 35 years, OA was 30 years. Male preponderance observed in OA (67%), female in LA (60%). Post-operative short hospital stay was 3-days in LA, 5-days in OA. Early return to work was 9-days in LA, 15-days in OA. Operative time was significantly shorter in LA which was 30-minutes and 40-minutes in OA. In laprascopic group, no complications was observed, in open group we had two post-operative infections.Conclusions: LA is an effective and safe option and the procedure of choice for most patients regardless of age, sex and BMI, with a statistically significant finding in regards to operation time in LA compared to conventional OA group.

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Hernias extending beyond the midpoint of the inner thigh in the standing position are called giant inguinal hernias or scrotal abdomen. They are rarely seen in common surgical practice. Huge inguinal hernias occur after years of neglect by the patient or in areas that are inaccessible to surgical services. Two cases of giant inguinal hernias which were managed successfully are presented here.Case 1: 80-year-old male patient presented with left giant scrotal abdomen for the past 12 years. Preoperatively, the pulmonary function test was found to be normal for his age. He was given incentive spirometry for a week. Perioperatively, the sac contained the entire small bowel, sigmoid colon, and omentum with inter bowel loop adhesions. Adhesions were released and it was repaired by hernioplasty with left orchidectomy. In the postoperative period, the patient was put on non-invasive ventilation for two days and then later was weaned off.Case 2: 42 years male patient presented with right-sided giant inguinoscrotal swelling for the past 15 years. The swelling was extending below midthigh. All the preoperative investigations were normal. Perioperatively, the sac contained omentum and small bowel and it was repaired by right hernioplasty. The postoperative period was uneventful and the patient recovered well.These are interesting cases of giant inguinal hernias. The occurrence of such potentially dangerous surgical problems is more common in low-to-middle income countries owing to the unavailability of surgical services. The management involves specific measures to prepare the patient adequately preoperatively especially to prevent respiratory complications in the postoperative period.Giant inguinal hernias can be comfortably managed if the patients are prepared adequately in the preoperative period. Their postoperative period will be uneventful if their pulmonary functions are normal.