LAPAROSCOPIC APPENDECTOMY; COST EFFECTIVE TECHNIQUE

Background: Appendectomy is one of the most common general surgical procedures and the most common 
emergency general surgical operation performed all over the world. In 1983, Kurt Semm performed the first 
successful Laparoscopic appendectomy (LA).
Aim of the work: The main limitations of LA are the longer operative time, which can be shortened by 
increasing skills and experience, and the increased cost, which can be minimized by adopting a modified low 
cost technique, which is the aim of our work.
Patients and Methods: One hundred and four patients were included in this study. All of them were having 
suspected appendicitis according to the clinical picture, Alvarado score, laboratory and ultrasonographic 
findings.
Patients were submitted to LA by using the modified technique with the details mentioned below. There was 
no need for the commercially used endo loops or endo GIA staplers.
The laparoscopic and histopathologic findings, the operative time and outcome are all recorded.
Results: For the included patients, three port technique was used in 74(71.2%) and two port technique in 
30(28.8%) of them.
The Laparoscopically inflamed appendix was found in 89(85.65%) and the histopathologically inflamed was 
confirmed in 92 (88.5%).
Concurrent pathology was found in 12(11.5%) and different pathology in 9 (8.7%).
The mean operative time of LA only was 42 minutes, and 95 minutes when other procedure was added.
Complications were reported in three cases. Conversion rate was 10.6%.and there was no mortality.
Conclusion: With this modified technique, we found Laparoscopic appendectomy is safe, cost effective and 
efficient, and we recommend it as first choice approach if not contraindicated.