Laparoscopic appendectomy: Early experience in a resource limited setting

Abstract

Background: Laparoscopic appendectomy commenced in the University of Benin Teaching Hospital (UBTH) in November 2020. With improved expertise, it has slowly gained grounds and is now readily available as a routine procedure in the general surgery service of UBTH.
Aim: This study is to highlight our early experience with Laparoscopic appendectomy in a low resource setting.
Patients and Method: This is a 2-year audit of Laparoscopic appendectomy in UBTH. The study included all patients who had the procedure over the study period. Anonymized patient data which included the age, sex, diagnoses, duration of bed stay, complications and histology of resected specimen were obtained and entered into a proforma. Data was analyzed using Microsoft Excel 2021.
Results: A total of 8 laparoscopic appendectomies were done over the 2year study period. The F:M ratio was approximately 1.7:1. The age range is 11 - 41years (cluster in the 3rd decade of life), mean age was 28.3±10.5years. Subacute appendicitis and acute appendicitis were diagnosed in study patients in equal proportions (50%). All procedures were done with reusable ports and the appendix base was ligated with Vicryl 1 extracorporeal Roeder’s knot. All resected specimen were retrieved directly from the 10mm port. Post-operative hospital stay was 1-2days with 75% discharge on day1. Patients returned to normal activity in 4-6days (mean
5.25±0.25days). There was no port site infection or herniation, no mortality. Acute appendicitis was reported in all resected specimens. Patient satisfaction score at first clinic visit was 8 – 10 out of 10 (mean score 9±0.2)
Conclusion: Early experience with Laparoscopic appendectomy in UBTH revealed a safe, effective procedure with low complication rate. Patient satisfaction was excellent with short post-operative hospital stay and early return to normal daily activities.