Arshad Amin, Shahid Nisar, Zafar Iqbal, Zeeshan Ahmad Saboor, Gulsharif.
Appendectomy with Minimal Skin Incision.
Ophthalmol Update Jan ;14(1):105-7.

Objective: Appendicitis is an acute and common pathology that needs surgery. In the USA, acute appendicitis occurs in approximately 7% of the general population. Laparoscopic surgery is the surgical method of choice for the treatment of acute appendicitis but this technique is not available in periphery of Pakistan. In this study a new method of appendectomy with minimal skin incision has been introduced that can be comparable with laparoscopic appendectomy. Material & Methods: We studied 100 patients with acute appendicitis who underwent open appendectomy with minimal skin incision in Bacha Khan Medical Complex, Shah Mansoor, Swabi. Under general anaesthesia and in the supine position, the skin was incised as long as 2 cm over the McBurney point. Open appendectomy was performed through this minimal incision. The patients were monitored for 24 hours in the hospital. All the patients were examined in outpatient department after two days of their discharge. Results: One hundred patients were evaluated in this study. There were 56 men (56%). The mean of the patients` age was 12.4 � 8.2 (� SD) year. The duration of the anaesthesia and surgery were 56 �14 and 38 � 8 minutes respectively. We also found that the time to liquid intake was 12 � 3 hours, and the duration of hospital stay was 24 � 2 hours. The mean of pain intensity in the post-op period was 2.8 � 1 (� SD). There were few surgical complications such as wound or intra-abdominal infection, however there was no need for re-operation. Conclusion Laparoscopic appendectomy has a higher cost than open appendectomy and laparoscopic surgery is not always available everywhere in Pakistan, particularly in Khyber Pakhtunkhwa. We showed in this study that by using `the appendectomy with minimal skin incision` the length of surgery, the length of anaesthesia, the length of hospital stay, the need for opioids and/or analgesics in the post-op period and post-op complications were within acceptable limits and also comparable to other reports of appendectomy. We can conclude that on the basis of this preliminary study, appendectomy with minimal skin incision can be recommended to those surgeons who do not have access to any kind of laparoscopic facilities.

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