Vol. 1, Issue 12, Part E (2015)

Abstract
Aims And Objectives -compare the outcome of laparoscopic and open appendectomy, in terms of Operating time. Intra operative and post operative complication. Hospital stay. Cost effectiveness.rnMaterial And Methods -This prospective comparative study was performed in JA Groups of Hospital and Gajra Raja Medical College Gwalior (M.P.), from November 2012 to November 2013. The merits and drawbacks of LA and OA were explained to all of the patients who suffered an attack of acute appendicitis. Patients who gave their informed consent were randomized to either LA or OA groups. 50 patients were included in this study. Our study plan was approved by ethical committee of our institution.rnResults- The study included 32 patients in open appendectomy group and 18 patients in laparoscopic appendectomy group. The two groups were similar to each other in terms of their age and sex characteristic.rnThe mean operation time was 60.8 and 45.7 min. respectively for the laparoscopic and open approach. There was significantly different between the two groups. Conversion rate of laparoscopic appendectomy to open procedure was 17%. 3 cases each were converted to open appendectomy. Laparoscopic appendicectomy was associated with less post operative pain with comparable complication rates. Duration of stay in the hospital was significantly less with the Laparoscopic procedure. The time of return to normal activity and work was significantly more for open approach as compared to the laparoscopic approach, the mean being 10.9 days for open appendectomy and 9.6 days for laparoscopic appendectomy. Laparoscopic appendectomy is thus a safe, simple and efficient technique for treatment of appendicitis in experienced hands. Cases with gangrenous appendicitis and chronic inflammation with fibrosis were the most difficult to complete laparoscopically. Laparoscopic approach enables appendectomy to be performed in 83% of cases with lesser morbidity and an earlier return to the normal activity and work. More benefit is to be obtained from the laparoscopic approach in cases of milder appendicitis and where the diagnosis is uncertain. rnConclusion -we conclude that LA is a considerably better procedure as compared to OL, the advantages of LA being as follows-Less operating time, Less post operative pain, Less hospital stay, Earlier return to normal activity, Better cosmetic acceptability of scar, Diagnosis of other abdominal pathology