Laparoscopic versus Open Appendectomy for the Treatment of Acute Appendicitis

Abstract

Abstract::Open appendectomy is the 'gold standard' for the treatment of acute appendicitis. Laparoscopic appendectomy though widely practiced has not gained universal approval. Although it is a generally safe operation, postoperative complications occur in few patients. Laparoscopic appendectomy was first described in 1983. Reports of early studies were equivocal with few studies evaluating analgesic requirements and the length of hospital stay. This study was aimed to compare laparoscopic with open appendectomy and ascertain the therapeutic benefit, if any, in the overall management of acute appendicitis. Key words:Laparoscopic appendectomy, Appendectomy, Appendicitis, Laparoscopic vs. open appendectomy Introduction:

Does Laparoscopic Appendectomy Impart an Advantage over Open Appendectomy in Elderly Patients?

“…Carbon dioxide pneumoperitoneum may have depressive effects on renal and cardiopulmonary functions, particularly in the elderly [18]. Also, it is hypothesized that infection may be spread intraperitoneal when an intra-abdominal infection is present during insufflations of carbon dioxide [19].…”

Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

“…Though open appendectomy is the 'gold standard' for the treatment of acute appendicitis, laparoscopic appendectomy is widely practiced now a day. 13 In 1981, Semm, from the Universitats Frauenklinik, Keil, Germany performed the first laparoscopic appendectomy 14 which is now considered as a safe alternative to open appendectomy in pediatric patients and results in shorter hospital stays, less post operative pain, less post operative complications, less postoperative ileus and of course, a better cosmesis. 13,14,15,16,17 In our study, out of 39 patients of laparoscopic Appendectomy, the bases of the Vermiform Appendices were tied with endoloops in most of the cases and in some, laparoscopic clips were used.…”

Gloved Appendectomy Performed With a Gloved Single Incision Laparoscopic Surgery Technique Versus Conventional Multiport Laparoscopic Technique

“…The control patients were specifically matched with respect to age and sex before analysis of surgical outcomes to serve as the best comparison cohort. Groups were compared using statistical analysis, including descriptive statistics using 2 and Student 2-tailed paired t-tests. Statistical significance is defined as P Ͻ .05.…”

“…The advantages of laparoscopic appendectomy include reduced postoperative wound complications, pain, and length of stay, as well as improved patient cosmesis and satisfaction. 2 The field of minimal access surgery has evolved dramatically in recent decades as a result of surgeons' creativity as well as advancement in surgical technological innovation. The evolution of surgery toward less-invasive approaches has stimulated more new techniques for entering the peritoneal cavity with the aim to reduce the number of incisions for ports and, even better, in some cases, eliminating skin incision through the use of natural orifices.…”