SINGLE INCISION LAPAROSCOPIC ASSISTED APPENDECTOMY IN VEDANTA INSTITUTE OF MEDICAL SCIENCES, AN EXPERIENCE OF 50 CASES.
DOI:
https://doi.org/10.32553/ijmbs.v3i10.688Keywords:
LA, SILA, VASAbstract
Introduction: Laparoscopic appendectomy (LA) has advantage to diagnose and to also treat appendicitis at the same time also it has a less postoperative pain and a faster return to work and normal activity. In a classic LA, three to four incisions are required for trocars placement. Technique of Single Incision Laparoscopic Appendicectomy (SILA) has been developed to reduce abdominal trauma, improve cosmesis, reductions in postoperative pain and hospital stay. Aim of this prospective study was to test the feasibility, safety and potential advantages of SILA
Material and Methods: Patients over the age of 18 with a diagnosis of acute abdomen, later on confirmed to acute appendicitis based on clinical findings, imaging and laboratory tests were included in the study. Outcome of the patient was assessed in the form of operative time, length of hospital stay and postoperative complications. Prophylactic antibiotics were given pre-operatively to all the patients included in the study. Technique was evaluated for operative time, post-operative pain, post-operative length of stay and complication rate. Post-operative pain was evaluated at 12 hrs, day 1 and day 2 post-operatively by using a visual analogue scale (VAS) which ranged from 0 to 10. Patients were evaluated on the 7th and 14th postoperative day for analysis of recovery, any surgical site infection, abscess formation, abdominal tenderness and aesthetic satisfaction.
Results: Mean age in years was 27±10.48 tears. There were 22 (44%) male and 28(56%) female. Mean duration of SILA procedure was 38±3.8 minutes. Hospital stay in days was 1.8±1.1. Patient returned back to work in 9±2.4 days. Post-operative pain was evaluated at 12 hrs, day 1 and day 2 post-operatively by using a visual analogue scale (VAS) which ranged from 0 to 10. After 12 hours score was 6.5, at day 1 4.0 and at day 2 it was 1.5.
Conclusion: Single incision appendicectomy operative time is less, pain is less and hospital stay is reduced thereby increasing the patient satisfaction and this technique is effective in terms of pain and hospital stay.
Keywords: LA, SILA, VAS