Abstract

Dr. Rudraiah H. G. M, Dr. Lincoln Samuel and Dr. E Rajya Lakshmi*

ABSTRACT

Background: Various peroperative indicators for conversion of laparoscopic to open appendicectomy exist. It is challenging to take tackle these indicators laparoscopically and hence minimize the need for conversion to open, which thereby proves to be efficacious in early post operative recovery and minimizing post operative complications. Objectives: The various per-operative findings which necessitate conversion of a laparoscopic appendicectomy to open and the advantages of laparoscopy over conversion to open with respect to the following were studied. ? Pre and intra operative indicators for guiding to proceed for open appendicectomy. ? Post operative pain and duration of analgesic use ? Postoperative complications like vomiting, ileus, intra abdominal abscess and wound infection ? Post operative length of hospital stay ? Return to work. Methods: From June 2011 to may 2013, 50 patients elder than 12 years with diagnosis of acute or recurrent appendicitis were entered into a prospective study the choice of operation being the laparoscopic appendicectomy technique. Statistical comparisons were performed using the chi-square test and Z test. Result: Out of 50 patients 48 patients successfully underwent laparoscopic appendicectomy irrespective of complicated or uncomplicated appendicitis. Only two patients underwent conversion to open. Interpretation and conclusion: The indications for conversion to open in our study were dense adhesions in 1(2%) patient and hemorrhagic ovarian cyst in 1(2%) which posed a risk of hemorrhage. The patients who underwent laparoscopy had significantly less post op pain, shorter duration of hospital stay and faster return to work.