Using Direct Trocar Technique in Laparoscopic Appendectomy: Our Results and Experience

Orhan Aras, MD, Hasan Altun, MD, Mehmet Okuducu, MD, Ender Onur, MD, Aziz Bora Karip, MD, Orhan Bat, MD, Hamit Kafkas Celik, MD, Kemal Memisoglu, MD

Fatih Sultan Mehmet Education and Research Hospital, Istanbul, TURKEY

Purpose: Appendicitis is the most common cause of acute abdomen, and appendectomy is the most frequent surgical procedure performed in the world. In recent times, laparoscopic appendectomy has been gaining increasing consensus, although comparison with traditional open surgery is still debated. There are a few techniques for first entry and carbon dioxide insufflation. This study assesses the safety and feasibility of the direct trocar insertion technique without pre-existing pneumoperitoneum in patients undergoing laparoscopic appendectomy.

Methods: The present investigation was designed as a prospective study in only one center. From 1 july 2010 to 1 July 2012, 141 patients underwent laparoscopic adjustable appendectomy. There were 59 women (%%41) and 82 men (%59). The mean age was 31 and ranged between 15 and 73 years.

Results: In this study we used only direct trocar insertion technique. There was no evidence of intestinal or vascular injury during trocar placement. Immediate minor complications were extraperitoneal insufflations in 5 patients, wound infection in 8 patients, intraabdominal abscess in 3 patients . No major complications were associated with this technique.

Conclusions: All complications related to the direct trocar insertion technique were minor and these complications did not affect the success of surgery. We concluded that the direct trocar technique for initial access in laparoscopic appendectomy is safe and provides quick entry into the peritoneal cavity.

Session: Poster Presentation

Program Number: P128

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