Cosmetic Result and Post-Operative Pain Reduction according to the Antepubic Location of Trocar Insertion in a Laparoscopic Appendectomy

You, Byung Hee; Lee, Myung Soo; Han, Se Hwan; Ryu, Seok Yong; Kim, Hong Joo; Kim, Young Duck; Kim, Hong Yong

Abstract

BACKGROUND: Laparoscopic surgery was first applied in appendectomies. However, the use of laparoscopic surgery has become more popular in other operation than appendectomies such as cholecystectomies and herniorrhaphies. Many surgeons have abandoned the laparoscopic appendectomy because they think the procedure is tedious and has no advantage over the simple open appendectomy. However, the incisional scar is an unavoidable sequela of an open appendectomy, and post-operative pain is bothersome in many cases.
METHODS
We carried out laparoscopic appendectomies in 49 consecutive patients by using antepubic trocar insertion to achieve maximum cosmetic effect and to minimize the post-operative pain. Fifteen patients (control group) underwent laparoscopic appendectomies with conventional trocar sites 2~3 cm above the symphysis pubis. Thirty-four patients (studied group) received a newly designed operation using an incision site on the symphysis pubis to maximize the cosmetic effect. We made a short subcutaneous tunnel from antepubic incision to facilitate the intra-abdominal dissection.
RESULTS
When we compare the post-operative results, there was no difference between the two groups with respect to operation time, post-operative pain, post-operative hospital stay, or complications.
CONCLUSIONS
A greater of the proportion patients who received the newly designed operation were satisfied with the cosmetic result.