Original Research Paper

Laparoscopic Assisted Appendicectomy Thesis Dissertation Submitted In Partial Fulfillment Of The Award Diploma In General Surgery Degree Of The University Of Kufa ,college Of Medicine

Abstract :

Background, Acute appendicitis is the most common cause of acute abdomen in young adults approximately 7% of population develop appendicitis in their life time thus making appendicectomy the most frequently performed abdominal operations the usual treatment of acute appendicitis is by appendicectomy which can be performed by either Open Appendicectomy or Laparoscopic Assisted AppendicectomyObjective,The laparoscopic appendicectomy can be performed using total intracorporeal or laparoscopic hand assisted open appendicectomy We present our experience of laparoscopic assisted appendicectomy(LAA) The objective was to assess the results retrospectively and prospectively in terms of specific related complications,operation time,hospital stay and return of bowel activity Methods,Between years 2006-2013 three ports laparoscopic assisted appendicectomy was performed in 90 patients in Najaf Al-Ashraf city with acute appendicitis,all patients with perforated and gangrenous appendicitis were included ,The appendicectomy was performed via an assisted three ports method using 5 or 7 or 10mm umbilical port,another 5mm port in right iliac fossa exactly against the base of appendix and 5mm port at left inguinal crease or suprapubic,all patients had their (LAA) done within 4-24 hours of admissionResult:Three ports laparoscopic assisted appendicectomy was successful in 98,88% of cases,acute appendicitis was the cause of acute abdomen in 100% of patients,the conversion to open appendicectomy was 1,11% of patients,the mean operation time was 32,5 minutes and the mean hospital stay was less than one day,the port site infection was 0% ,visceral injury was 0% and intra-abdominal abscess also 0%Conclusion:Laparoscopic Assisted Appendicectomy can be converted to total intracorporeal appendicectomy or to open appendicectomy when required and has advantage of full laparoscopy of full abdomen,it has no limitations in cases of extreme obesity,thick mesentry,gangrenous appendix,very large and thick appendix and difficulty in finding the appendix,control of bleeding ,division of adhesions and deal with other associated pathology,The overall morbidity was very low,there were no specific complications related to

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