LAPAROSCOPIC APPENDECTOMY

Recent reports have suggested that laparoscopic appendicectomy (LA) confers some advantages over open appendicectomy (OA). In a prospective study we compared the results of the first 75 patients undergoing LA with 50 patients undergoing OA. Post-operative recovery, complications, and return to normal activities were compared in the two groups. Although the overall complications were similar in the two groups, three patients developed major post-operative complications following LA. These included small bowel perforation due to a diathermy injury, right iliac fossa haematoma, and small bowel obstruction. Hospital stay was significantly reduced after LA. Follow-up demonstrated a shorter convalescent period at home and faster return to normal activity. In conclusion this study demonstrates that LA is superior to OA in terms of hospital stay and return to normal activity. However, in less experienced hands the potential hazards of significant complications remain a concern. The presence of one major complication related to the laparoscopic technique in this study highlights the importance of training if the widespread introduction of this approach is to be advocated.