Publication:

Laparoscopic adhesiolysis in treatment of post appendectomy pain in right iliac fossa- an evaluation

Background Post-operative complications following appendectomy are relatively not uncommon and pain during this period is sometimes seen. Persistent or reappearance of similar pain causes the loss of patient’s confidence on the procedure itself as well as despair for surgeons.

Methods The study was conducted at our institution to determine the cause of post appendectomy right iliac fossa pain and to evaluate the role of laparosopic adhesiolysis as a therapeutic tool. 35 patients with post appendectomy right iliac fossa pain were included in the study and outcome of post-operative peri-caecal adhesions (if found) treatment with laparoscopic adhesiolysis was assessed.

Results 80% of the 35 patients were in the age group of 18-38 years. 37.14% (13 patients) were symptomatic within 1 year of appendectomy. Pain due to post-operative adhesion was found in 20% (7) of the patients. With laparoscopic adhesiolysis, the diagnostic accuracy rate was 78.57% and therapeutic relief in pain was 85.72% of the patients in our study.

Conclusions Patients presenting recurrent pain in right iliac fossa, after appendectomy should not be overlooked. Patients with recurrent right iliac fossa pain following appendectomy may benefit from laparoscopy, both as a diagnostic tool and with the added advantage of treating the patients simultaneously in the form of laparoscopic adhesiolysis. Adhesiolysis has offered pain free life as long as our follow up is concerned.