Published: 2019-05-28

Comparative study on surgical outcomes of needle port assisted two port laparoscopic appendicectomy verses conventional three-port laparoscopic appendicectomy

Rajiv Sonarkar, Ashutosh Ghuge, Murtaza Akhtar


Background: Conventional three port laparoscopic appendicectomy is fast becoming a procedure of choice for appendicitis. Needle port assisted two port laparoscopic appendicectomy is the procedure with similar technique as conventional procedure but has its distinctive advantages. The present study aims to compare the results of needle port assisted two port and conventional three port laparoscopic appendicectomy.

Methods: In comparative non-randomized study patients with acute appendicitis, recurrent appendicitis and patients posted for interval appendicectomy of age >18 years, both gender without co-morbidity were enrolled as subjects. Non-consenting patients were excluded. The study factor was needle port assisted two port and conventional three port laparoscopic appendicectomy procedure. The allocation to each procedure was done at random. The outcome factors were compared between both groups.

Results: A total of 91 patients with a mean age of 29.77 years and F:M ratio of 1.67:1 were enrolled, of them 31 underwent needle port assisted two port laparoscopic appendicectomy. The mean operative time for two port was 53.38±7.97 min as compared to conventional three port was 44.65±5.86 min which was statistically significant but cosmetic outcome was better as well as statistically significant with two port procedure. The post-operative pain, intra-operative and post-operative complications were compared between these groups but were statistically not significant.

Conclusions: Needle port assisted two port laparoscopic appendicectomy appears to give better cosmetic results and can be a good surgical alternative modality for uncomplicated appendicitis.


Conventional three-port laparoscopic appendicectomy, Needle port assisted two-port laparoscopic appendicectomy

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Addiss DG, Shaffer N, Fowler BS, Tauxe R V. The epidemiology of appendicitis and appendicectomy in the united states. Am J Epidemiol. 1990;132(5):910-25.

Semm K. Endoscopic Appendectomy. Endoscopy. 1983;15(02):59-64.

Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X. Laparoscopic versus conventional appendicectomy - a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2010;10(1):129.

Yagnik VD, Rathod JB, Phatak AG. A retrospective study of two-port appendicectomy and its comparison with open appendicectomy and three-port appendectomy. Saudi J Gastroenterol. 2010;16(4):268-71.

Vilallonga R, Barbaros U, Nada A. Single-port transumbilical laparoscopic appendectomy: a preliminary multicentric comparative study in 87 patients with acute appendicitis. Minim Invasive Surg. 2012;2012:492-409.

Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, et al. Laparoscopic Versus Open Appendectomy. Ann Surg. 2004;239(1):43-52.

Cox MR, McCall JL, Toouli J. Prospective randomized comparison of open versus laparoscopic appendectomy in men. World J Surg. 1996;20:263-6.

Udwadia TE. Single-incision laparoscopic surgery: An overview. J Minim Access Surg. 2011;7(1):1-2.

Rao PP, Rao PP, Bhagwat S. Single-incision laparoscopic surgery-current status and controversies. J Minim Access Surg. 2011;7(1):6-16.

Chamberlain RS, Sakpal SV. A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg. 2009;13(9):1733-40.

Romanelli JR, Earle DB. Single-port laparoscopic surgery: an overview. Surg Endosc. 2009;23(7):1419-27.

Husain M, Sahu S, Sachan P. Two-Port Laparoscopic Appendectomy. Int J Surg. 2010;27(2).

Gupta R, Singal R, Sharda VK, Singh B, Ahluwalia JS, Bhatia G, et al. Two port laparoscopic assisted appendicectomy versus three port laparoscopic appendicectomy: A prospective study of 50 cases. TJMR J. 2015;18(1):1.

Rammohan A, Jothishankar P, Manimaran AB, Naidu R M. Two-port vs. three-port laparoscopic appendicectomy: A bridge to least invasive surgery. J Min Access Surg. 2012;8:140-4.

Mhatre HP, Kanake VB, Nandu VV. a new technique in laparoscopic appendicectomy. 2015;1(5):215-9.

Sutariya P, Chavda J. two ports versus three port laparoscopic appendicectomy- a step further towards minimal invasiveness. Int J Res Med. 2015;4(1):98-101.

Mujawar P, Patel N, Gouhar R, Mishra A. Comparative study between laproscopic appendicectomy and Laproscopic assisted appendicectomy. Global J Res Analysis. 2018;7(9):227-8160.

Kollmar O, Z‘graggen K, Schilling MK, Buchholz BM, Buchler MW. The suprapubic approach for laparoscopic appendectomy. Surg Endosc. 2002;16:504-8.