Comparison of all three 5 mm ports Laparoscopic appendectomy with Conventional laparoscopic appendectomy – a Hospital based randomised controlled Trial

Abstract

Background and objectives: Acute appendicitis is one of the most common causes of acute abdomen. It ranges from subacute inflammation to perforation. Its management, appendectomy was initially described by Claudius Amyand in 1753 has evolved remarkably; from a large McBurney’s incision to minimally invasive approach. Due to increased availability of laparoscopy, it is currently the preferred approach of choice for appendectomy. With advances in minimal access techniques, various attempts are being made and studied to reduce the invasiveness by reducing the number and size of ports, such as single incision laparoscopic appendectomy, double incision laparoscopic appendectomy and NOTES. However, there are several drawbacks i.e., the requirement of specialized instruments and skills, difficulty in triangulation of instruments, increased cost, a longer learning curve, increased incidences of incisional hernia and unsatisfactory cosmesis, and hence leading to various speculations and debates. Therefore, we hypothesize that the use of all three 5 mm ports technique can be used to reduce postoperative pain and achieve satisfactory cosmesis, while retaining the same skillset as conventional laparoscopic appendectomy. This study aims to compare patients undergoing all three 5 mm port laparoscopic appendectomy and conventional laparoscopic appendectomy terms of postoperative pain and cosmesis, and rate of conversion to a 10 mm port. AIM: To evaluate the efficacy of all three 5 mm ports laparoscopic appendectomy over conventional laparoscopic appendectomy. OBJECTIVES: Comparison of the two techniques of laparoscopic appendectomy with regards to: