Abstract
Objectives: Appendicitis, being the frequent surgical emergency condition, warrants surgery immediately or electively in order to alleviate complications. Appendectomy can be done through laparoscopic or open access. The incision for open appendectomy varies according to clinical condition of the patient and the surgeon’s preference. This study aims at bringing out the advantage, utility and cosmesis of using a mini incision for open appendectomy at our hospital.
Materials and Methods: This is a prospective study on patients getting admitted with clinical and radiological evidence of appendicitis. A total of 50 cases were studied during the period from 2016 to 2019. All the patients underwent open appendectomy through a mini incision measuring 2 to 2.5cm preferably under regional anaesthesia. The patients’ complete history, clinical profile, operative details, post-operative status, length of hospital stay, condition during follow up were recorded.
Results: Out of 50 patients who underwent mini-incision appendectomy, 31 (62%) were male and 19 (38%) were female. 6 cases (12%) required an extension of the incision up to 3.5cm due to difficulty in delivering. Surgical site infection occurred in 3 patients (6%), which were treated conservatively. The average operative period was 28 minutes (20-45 minutes). All the patients had negligible post-operative pain. The condition during follow up was uneventful and the patients had very minimal scar.
Conclusions: The mini-incision appendectomy is thus a safe technique for performing open appendectomy with cosmetic advantage.
Keywords: Appendicitis, Appendectomy, Mini incision.
References
- Rothrock SG, Pagane J. Acute appendicitis in children: emergency department diagnosis and management. Ann Emerg Med. 2000;36:39-51
- Fitz RH. Perforating inflammation of the vermiform appendix: with special reference to its early diagnosis and treatment. Am J Med Sci. 1886;92:321–346
- Ditillo MF, Dziura JD, Rabinovici R. Is it safe to delay appendectomy in adults with acute appendicitis? Ann Surg. 2006;244.
- Amyand C. Of an inguinal rupture, 1ith a pin in the appendix coeci, incrusted with stone; and some observations on wounds in the guts. Phil Trans Royal Soc. 1736;39:329.
- McBurney, “The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating,” Annals of Surgery, vol. 20, pp. 38–43, 1894.
- M. Townsend and B. Ever, Atlas of General Surgical Techniques, 2010.
- Rintoul RF. Operation on the appendix. In: Farquaharson’s (editor). Textbook of operative surgery 8 th edition Churchill Livingstone. 1995:452- 4.
- V. Sakpal, S. S. Bindra, and R. S. Chamberlain, “Laparoscopic cholecystectomy conversion rates two decades later: an analysis of surgeon and patient-specific factors resulting in open conversion,” Journal of the Society of Laparoendoscopic Surgeons, vol. 14, no. 4, pp. 476–483, 2011
- Mantoglu B, Karip B, Mestan M, İscan Y, Agca B, Altun H, et al. Should appendectomy be performed laparoscopically? Clinical prospective randomized trial. Ulus Cerrahi Derg. 2015;31:224-8.
- Ciftci F. Laparoscopic vs mini-incision open appendectomy. World J Gastrointest Surg. 2015;7(10):267-72.
- Jelarko C, Davis L. A transverse lower abdominal appendectomy incision with minimal derangements. Surg Gynaecol Obstet. 1973;136:45.
- Temple WJ. Bikini appendectomy incision, an alternative to the Mc Burney’s approach for appendectomy. Canadian J Surg. 1990;33(5):333-4.
- Huochuan L, Huichang L, Maxwell micro incision appendectomy experience of 86 cases. Guangzhou Medical Journal. 2009;02:33.
- Bhasin SK, Dhar S. Mini-appendectomy (an Experience of 100 cases). JK Practioner. 2005;12(1):11-3.
- Sauerland S, Lefering R, Neugebauer E. Laparascopic versus open surgery for suspected appendicitis. The Cochrane Collaboration. 2007;4:1-74.
- Shah B, Vaidhya N, Anchalia MM. Comparative study between laparscopic appendicectomy and small incision open (mini lap) Appendicectomy in cases of acute appendicitis. Int J Sci Research. 2013;2(11):2319-64.
Corresponding Author
Dr C. P. Mohan. M.S.
Department of General Surgery, Rajah Muthiah Medical College, Annamalai University,
Chidambaram – 608002, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.159
