Author(s): Savalam Bujjitha Rathna Kishore1, Gedala Sridhar2, T. Narasimha Sai Kiran3, Gayathri Kolagatla4
Reginald Fitz in 1986, first described acute appendicitis. Since the acute appendicitis was first described, the pathology remains the most common intra-abdominal condition requiring emergency surgery. The life time risk of having acute appendicitis is about 8%. Traditionally, the treatment of choice has been surgery. Before the only option was the open laparotomical meaning opening the abdominal cavity was the mode of operation. Laparoscopic appendectomy was described by Semm in 1983. This method was new and had its own benefits but this particular procedure has struggled to prove its superiority over the open technique. This is contrast to laparoscopic cholecystectomy which has promptly become the gold standard for gallstone disease despite little scientific challenge. This peculiarity might be because of the fact that the Open Appendectomy was used for centuries with good effect. The particular procedure withstood the test of time for more than a century since its introduction by McBurney unlike cholecystectomy. Open surgery is typically completed using a small right lower quadrant incision between the point joining the lateral one-third and medial two-third of a line drawn from anterior-superior iliac spine and the umbilicus. The postoperative recovery is usually uneventful. The overall mortality of OA is around 0.3% and morbidity about 11%. Despite numerous randomised trials, several meta-analysis and systematic critical reviews, the clear cut winner is unannounced. A sincere effort has been put to understand the different pros and cons of the two methods so that the patient can be benefited.
One Hundred cases were studied in the Department of Surgery, King George Hospital, Visakhapatnam, Andhra Pradesh from 01-09-2015 to 29-02-2016.
Out of these, fifty cases underwent open surgery and the rest through laparoscopic surgery.
The first group (Open Surgery) thus consisted of 50 cases and the second group (laparoscopic) consisted of fifty cases.
Except for the cost effectiveness, the laparoscopic technique has an upper hand in every aspect compared.
The best way that is available to operate is the laparoscopic. But the conventional open access surgery has to be used whenever the need arises especially when the cost-effectiveness is the topic of dispute especially in a developing country like ours. The cost effectiveness of the laparoscopic surgery has to be worked out for the better usage of the procedure.