Our Experience with Little Hole Appendicectomy and Description of How We Do It

Abstract

Background: Appendicectomy is among the commonest performed surgery. Scarless or minimal scar is now sought by patients. The value of laparoscopic over open appendicectomy is not establish to draw definitive conclusions and generalization, unlike in cholecystectomy; with higher cost, three scars sites and longer operative time. Minimal access appendicectomy is performed via open surgery with only a scar and has been documented. Our technique is also a modified Lanz that places the skin incision 1.5cm medial to the anterior superior iliac spine which gets easily on to the caecum with limited obscured small bowel. The description of technique adds to medical literature and experience in homogenous black population which this paper addresses.
Objectives: To review our little hole open appendicectomy and describe how we do it. To serve as a teach-book for rising scarless surgery requests in our African setting, though not intended for apprentice surgeon.
Methodology: This is a retrospective study of little hole appendicectomies from 2000 -2010.
Result: Thirty nine (39) patients were reviewed,33 females (84.6%) and 6 males (15.38%). 4 patients had incision size 1 cm, 27 patient had 1.5 cm and 8 patients had incision of 2cm.The shortest operative time was 20 minutes and the longest was 55 minutes with a mean operative time of 27.9 minutes.
Conclusion: with appropriate patient selection, little hole open appendicectomy is effective and has a good outcome.