Publication:

Two-port vs. conventional (three-port) laparoscopic appendicectomy: a new technique in laparoscopic appendicectomy

Background Three-port laparoscopic appendicectomy has proven its worth in the management of appendicitis. From a cosmesis, the umbilical and suprapubic portsites are hidden by natural camouflages, the Right Iliac Fossa (RIF) port is the only visible external sign of surgery. The two-port technique avoids even this marker of abdominal invasion.

Methods 58 patients were studied for this study. Data was collected prospectively. The two port appendicectomy was performed with 10 mm umbilical working port and 5 mm supra-pubic camera port. A stitch was taken transparietaly in RIF which was under camera guidance passed through the tip of appendix and held with suture to retract the appendix. The base was ligated with an intra-corporeal knot and appendix cut and delivered out. Three port appendicectomy was performed via the 10 mm umbilical, 5 mm supra-pubic and 5mm right iliac fossa ports. The appendicular stump was ligated with an endoloop or an intra-corporeal knot, appendix cut and delivered out

Results 58 patients underwent surgery over the one year period for appendicitis. Out of 26 cases attempted, the two port appendicectomy was successful in 21 cases, with conversion to the three-port technique in 4 and conversion to open in 1 case. The complication rates, return to work were comparable between the two groups. Duration of operation was more whereas length of hospital stay was less in two port appendicectomy group as compared to conventional laparoscopic group.

Conclusions Patients who underwent two port appendicectomy had a cosmetically better appearing scar than compared to three port appendicectomy cases.