Laparoscopically Assisted Appendicectomy in Adults: A Comparative Analysis

Abstract

Background; Laparoscopic appendicectomy (LA) has always generated controversy due to its expensive and time consuming nature. Open appendicectomy (OA) on the other hand is cheaper and faster to perform but lacks the advantage of visualising the rest of the peritoneal cavity for associated pathologies. Laparoscopically assisted appendicectomy (LAA) in comparison combines the benefits of the other methods at a cheaper rate than the laparoscopic appendicectomy but is performed mainly in children. This study was aimed at evaluating the feasibility of LAA in adults compared to LA and OA. Methodology-This was a combined prospective and retrospective evaluation of patients that underwent appendicectomy using three different methods. Results The prospective arm of the study consisted of a total of 64 patients, 28 of whom had laparoscopic appendicectomy while 36 had laparoscopically assisted appendicectomy. The retrospective arm included 40 patients that had open appendicectomy. The costs of the procedures were $315 (OA), $630(LAA) and $1260 (LA). The mean operating time for the different methods were 30, 33 and 60 minutes for OA, LAA and LA respectively while the duration of hospital admission were 24hours each for OA and LAA but 48 hours for LA. Associated intra-abdominal pathologies were found in 13 patients (20.3%) that had LAA and LA while none was documented for OA. Conclusion Laparoscopically assisted appendicectomy (LAA) in adults can be done at a significantly reduced cost and shorter operating time when compared to Laparoscopic appendicectomy (LA), and has the ability to detect other intraabdominal pathologies as opposed to open appendicectomy.