Retrospective analysis of laparoscopic versus open appendectomy for the treatment of acute appendicitis

Ritvik Resutra, Haroon Salaria, Rajive Gupta


Background: Acute appendicitis is one of the most commonly encountered emergency by the general surgeons and appendectomy is the most common surgery performed in the world. Although open appendectomy is preferred by many surgeons, yet the laparoscopic approach is gradually replacing open surgery for treatment of acute appendicitis.

Methods: A total of 400 patients of acute appendicitis were operated, 200 by laparoscopic appendectomy and 200 by open method by a single surgeon at various private hospitals in Jammu (Jammu and Kashmir), India over a period of three years from July 2017 to July 2020. The two groups were compared with respect to operative time, duration of hospital stay, post-operative pain, complication rate and time taken to resume routine activity and cosmetic satisfaction of the patients.

Results: Results were found to be better with the laparoscopic technique. There was significantly less pain in the postoperative period with faster recovery, early resumption to work, reduced postoperative complications and better cosmetic satisfaction of the patients operated by the laparoscopic appendectomy technique as compared to open surgery.

Conclusions: Laparoscopic appendectomy is safe and feasible technique in expert hands, for treatment of acute appendicitis with results comparable to the open appendectomy, with no obvious increase in complications and is definitely a procedure of choice for the management of acute appendicitis.


Appendectomy, Acute appendicitis, Trocar, Laparoscopic appendectomy, Emergency

Full Text:



Ellis H, Nathanson LK. Appendix and appendectomy. In Maingot’s Abdominal Operations. Ed. Zinner MJ. Mc Graw-Hill. New York. 10th ed. 2001;2:1210-20.

Gorenoi V, Dintsios CM, Schonermark MP, Hagen A. Laparoscopic vs. open appendectomy: systematic review of medical efficacy and health economic analysis. GMS Health Tech Assess. 2007;2:1-12.

Sporn E, Petroski GF, Mancini GJ, Astudillo JA, Miedema BW, Thaler K. Laparoscopic appendectomy is it worth the cost? Trend analysis in the US from 2000 to 2005. J Am Coll Surg. 2009;208:179-85.

Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132(5):9-10.

Chaudhari YP, Jawale PG. Prevalence of appendicitis at surgery inpatient department of a tertiary care hospital: a descriptive study. Med Pulse Int Med J. 2015;2(11):768-70.

Mishra RK, Hanna G, Cuschieri A. Laparoscopic versus open appendectomy for treatment of acute appendicitis. World J Laparosc Surg. 2008;1(1):19-28.

Aziz O, Athanasiou T, Tekkis PP, Pukayastha S, Haddow J, Malinovski V, et al. Laparoscopic versus open appendectomy in children: A meta-analysis. Ann Surg. 2006;243(1):17-27.

De U. Laparoscopic versus open appendectomy: An Indian perspective. J Min Access Surg. 2005;1:15-20.

Kathouda N, Friedlander MH, Grant SW, Achanta KK, Essani R, Paik P, Velmahos G, Campos G, Mason R, Mavor E. Intraabdominal abscess rate after laparoscopic appendectomy. Am J Surg. 2000;180(6):456-9.

Krisher SL, Browne A, Dibbins A, Akacz N, Curci M. Intraabdominal abscess rate after laparoscopic appendectomy for perforated appendicitis. Arch Surg. 2001;136(4):438-41.

Paik PS, Towson JA, Anthone GJ, Ortega AE, Simons AJ, Beart RW, et al. Intraabdominal abscess following laparoscopic appendectomies. J Gastroentest Surg. 1997;1(2):188-93.

Barkhausen S, Wullstein C, Gross E. Laparoscopic versus conventional appendectomy-a comparison with reference to early postoperative complications. Zentaralbl Chir. 1998;123(7):858-62.

Tang E, Ortega AE, Anthone GJ, Bears RW. Intraabdominal abscess following laparoscopic and open appendectomies. Surg Endosc. 1996;10:327-8.

Piskun G, Kozik D, Rajpal S, Shaftan G, Fogler R. comparison of laparoscopic, open and converted appendectomy for perforated appendicitis. Surg Endosc. 2001;15(7):660-2.

Krisher SL, Browne A, Dibbins A, Tkacz N, Curci M. Intra-abdominal Abscess after Laparoscopic Appendectomy for Perforated Appendicitis. Arch Surg. 2001;136:438-41.

Stöltzin H, Thon K. Perforated appendicitis is laparoscopic appendectomy advisable? Dig Surg. 2001;17(6):610-6.

Johnson AB, Peetz ME. Laparoscopic appendectomy is an acceptable alternative for the treatment of perforated appendicitis. Surg Endosc. 1998;12(7):940-3.

Garrard CL, Clements RH, Nanney L, Daviddson JM, Richards WO. Adhesion formation is reduced after laparoscopic surgery. Surg Endosc. 1999;13:10-3.

Enochsson L, Hellberg A, Rudberg C, Fenyo G, Gudbjartson T, Kullman E, Ringqvist I, Sorensen S, Wenner J. Laparoscopic versus open appendectomy in overweight patients. Surg Endosc. 2001;15(4):387-92.

Shayani V. Mucinous cystadenoma of the cecum missed at laparoscopic appendectomy. Surg Endosc. 1999;13:1236-7.

Jaschinski T, Mosch C, Eikermann M,Neugebauer EA. Laparoscopic versus open appendectomy in patients with suspected appendicitis: a systemic review of meta-analysis of randomized controlled trials. BMC Gartroenterol. 2015;15:48.

Rashid A, Nazir S, Kakroo SM, Chalkoo MA, Razvi SA, Wani AA.Laparoscopic versus open appendectomy: a prospective randomized controlled trial. Surg Laparosc Endosc Percutan Tech. 2013;23:93-6.

Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg. 2005;242(3):439-50.

Minne L, Varner D, Burnell A, Ratzer E, Clark J, Haun W. Laparoscopic vs open appendectomy: prospective randomized study of outcomes. Arch Surg. 1997;132(7):708-12.

Hebebrand D, Troidl H, Spangenberger W. Laparoskopische Oder Klassische appendektomie? Eine prospective randomisierte studie. Ghirurg. 1994;65:112.

Mutter D, Vix M, Bui A, Evrard S, Tassetti V, Breton JF, et al. Laparoscopy not recommended for routine appendectomy in men: results of a prospective randomized study. Surgery. 1996;120(1):71-4.

Wagner M, Aronsky D, Tschudi J, Metzger A, Klaiber C. Laparoscopic stapler appendectomy. Surg Endosc. 1996;10:895-9.

Yang HR, Wang YC, Chung PK, Jeng LB, Chen RJ. Laparoscopic appendectomy using the LigaSureTM vessel sealing system. J Laparoendoscopic Advan Surg Tech. 2005;15(4):353-6.

Heikkinen TJ, Haukipuro K, Hulkko A. Cost-effective appendectomy. Open or laparoscopic? A prospective randomized study. Surg Endosc. 1998;12(100):1204-8.

Sartelli M, Baiocchi GL, Di Saverio S. Prospective observational study on acute Appendicitis worldwide (POSAW). World J Emerg Surg. 2018;13:19.