Interval Laparoscopic Appendectomy: An Observational Study from a Tertiary Care Centre of a Developing Nation

Abstract

Background: Laparoscopic surgery requires an elaborate console and sophisticated laparoscopic instruments such as endoscopic stapler, endoscopic clip, Ligasure, and Harmonic scalpel which attribute to higher cost of surgery. The aim of this prospective observational study was to evaluate the safety profile and outcome of Laparoscopic Appendectomy using basic laparoscopic instruments and low-cost suture materials in a tertiary care hospital of a developing nation. Materials and Methods: This was an observational prospective study that was done in Department of Surgery, Government Medical College, Jammu for a period of three years. After applying the exclusion criteria, 50 consecutive patients were enrolled in this study. After all the baseline investigations and adequate imaging, patients were subjected to laparoscopic appendectomy. Various parameters were documented, and data analysed. Result and Discussion: Majority of the patients belonged to 3rd and 4th decade of life. Mean operating time was 51 minutes with a standard deviation of ± 6.4 minutes. In this study, 29 patients had post-operative hospital stay of less than 2 days, 19 patients had a post-operative stay of greater than 2 days while 2 patients had an hospital stay of more than one week. Post-appendectomy, 8 patients developed complications in form of port site sepsis, fever, and localised abscess formation. All such complications were taken care of with conservative means. Conclusion: Even with limited setup, laparoscopic appendectomy in the hands of an expert is a safe and feasible. The cost of a laparoscopic appendectomy can be substantially reduced using reusable items instead of disposable ones without compromising the safety of the patient.