Jalbaji More, MS1, Jasmine Agarwal1, Eham Arora1, Gagandeep Talwar1, Chintan Patel, MS, DNB, FMAS, FIAGES, FBMS2, Saurabh Gandhi, MS, FMAS, FIAGES, FBMS, FALS1. 1Grant Government Medical College & Sir JJ Group of Hospitals, India, 2Kiran Multi-Super Specialty Hospital & Research Center, Surat, India
OBJECTIVE: To evaluate the feasibility, cost effectiveness and safety of Single incision laparoscopic surgery using routine laparoscopy instruments.
METHOD: 64 cases of acute appendicitis and 56 cases of symptomatic gallstone disease were included in study. 120 cases were enrolled in study and prospective observational study was performed. Ruptured appendicitis/abscess formation were excluded from study. Similarly Empyema Gallbladder / Gallbladder perforation were also excluded
RESULTS:Total 120 cases included; 64 cases of Appendicitis and 56 cases of symptomatic Cholelithiasis.
Mean age of appendectomy group was 28.71 ± 9.69 years and mean age of cholecystectomy group was 36.71 ± 10.48 years. In our study, Mean operative time for SIL Appendectomy was 42.04 ± 5.74 min. Post-operative fever was noted in 10 cases (14.25%). Mean post-operative pain as per VAS score taken after 24 hours, on POD 2 was 2.14. Average post op stay in hospital was 2.14 days, Port site infection occurred in one case (4.17%). Patient satisfaction score obtained on the scale of 1 to 10 on one month follow up was 7.95, while scar cosmesis score was 7.9.
In our study, 56 cases underwent SIL cholecystectomy, of which 21 were male (36.8%) and 35 were females (41.2%), and mean age of patients was 36.71yrs. Mean operative time in our study was 75.21 min, Mean post-operative pain taken on POD 2 as per VAS score was 2.91, Mean post-operative hospital stay was 2.1 days, Port site infections occurred in 2 cases. Post-op fever was noted in 6 cases, post-operative patient satisfaction score obtained at 1 month follow up was 7.73 and Scar score of 7.84 on the scale of 0 to 10. No case required drain placement and conversion.
CONCLUSION: SILS can be performed using conventional laparoscopic instruments especially in a government setup where per capita economic burden to patient will be less. Though it has more operative time, it has comparably less post-operative hospital stay, causes less pain, and has significantly more patient satisfaction regarding post- operative scar and cosmesis.
Since SILS has more patient acceptance and satisfaction, it can be offered to all patients undergoing laparoscopic surgery. It is very useful in government setup where lower economic class of patients will also benefit, irrespective of unavailability of special instruments and financial constraints, as it can be performed using routine laparoscopic instruments.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87291
Program Number: P678
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster