Abstract
Background/Objective:
Laparoscopic appendectomy is commonly performed through a 3-port technique. We compared our experience of 2-port laparoscopically assisted appendectomy with 3-port LA (laparoscopic appendectomy) in uncomplicated appendicitis in terms of efficacy, safety, and cost.
Methods:
We evaluated 86 children ages 3 to 12 years with uncomplicated appendicitis undergoing laparoscopic appendectomy (2-port, n = 45; 3-port, n = 41) during a 4.5-year period. The technique depends on the surgeon's preference and the position of the appendix. We excluded all children (2-port, n = 8; 3-port, n = 15) with complicated appendicitis.
Results:
There were no differences at the time of presentation in age, gender, weight, duration of symptoms, or severity of disease for both techniques of laparoscopic appendectomy. In 2-port laparoscopically assisted appendectomy, the operative (40 vs. 68 minutes, P < .05) and anesthesia (67 vs. 96 minutes, P < .05) times were shorter. The average postoperative stay (2.5 days in 2-port vs. 3.3 days in 3-port) and analgesia requirement were also less in 2-port laparoscopically assisted appendectomy. Two children (3-port laparoscopic appendectomy) required conversion to open appendectomy. There were no postoperative complications in either group. The extra cost of endo-loops with 1 port and the 1-day hospital stay was saved by using 2-port laparoscopically assisted appendectomy.
Conclusion:
We concluded that 2-port laparoscopically assisted appendectomy is a safe and effective alternative for the management of uncomplicated appendicitis. When successful, the overall cost is less with 2-port laparoscopic appendectomy because it is quicker to perform, requires less anesthesia time and no endo-loops, endo-clips, or endo-GIA, and results in a shorter hospital stay and less postoperative analgesia.
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