Single Incision Laparoscopic Appendicectomy (SILA) using Conventional Instruments vs Classical Laparoscopic Appendicectomy (CLA)
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: Laparoscopic appendicectomy is a widely accepted minimally invasive procedure due to its advantages like reduced postop pain, shorter hospital stay, quicker recovery and improved cosmesis. In laparoscopic appendectomy, three ports are required for the placement of trocars. Single incision laparoscopic appendicectomy(SILA) has more advantages of being further minimally invasive in form of further reduction in ports, post operative pain, improved cosmesis and is being accepted as a technically viable option for removal of the appendix. Material and methods: The study was conducted over a period of 3 years from April 2012 to April 2015 at the department of General Surgery in two tertiary care service hospitals. We performed appendicectomy in fifty patients by classic three port and single incision laparoscopic approach technique successfully. SILA was performed by the single experienced laparoscopic surgeon. 50 patients were randomized into two groups. Group I underwent SILA and Group II three port appendicectomy. The patients were followed up till Dec 2016 thus the period of followup ranged from 8 months to 24 months. Results: There was significant difference with mean operative time for SILA being longer (mean 49.32±11.75 minutes) ranging from a maximum of 70 minutes to a minimum of 30 minutes. Whereas for three port laparoscopic appendicectomy mean time was 25.64±6.28 minutes ranging from a maximum of 35 minutes to 15 minutes minimum. It is seen that there was a significant difference between the pain suffered after first 6 hours of operation but no difference was associated in pain after 12 hours and 24 hours. Fifteen patients were discharged on the first postoperative day on semisolid diet. Analgesic use and visual pain score was less than multiport laparoscopic appendectomy. One patient developed stitch abscess which required drainage through port scar. Surgical wound healed well in all patients with inconspicuous umbilical scar. Conclusion: SILA is technically feasible and safe in the hands of experienced minimally invasive surgeons. It is a new technique developed for performing appendicectomy with invisible scar and is becoming popular amongst surgeons and patients.
Authors and Affiliations
Subhash Chawla, AK Gupta, Lipika Chawla, Himani Chawla
Keywords
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