Open vs lap appendicectomy in government hospital

1. THESIS INTRODUCTION
DR. VINOTH KUMAR S
FIRST YEAR POST GRADUATE STUDENT
DEPARTMENT OF GENERAL SURGERY
GOVERNMENT THIRUVANNAMALAI MEDICAL COLLEGE AND HOSPITAL

2. CONTENTS
 TOPIC
 INTRODUCTION
 OBJECTIVES
 METHODOLOGY
 INCLUSION CRITERIA
 EXCLUSION CRITERIA
 PROCEDURE
 REFERENCES

3. TOPIC
• A Comparative Study on Open vs Laparoscopic Appendicectomy IN
GOVERNMENT THIRUVANNAMALAI MEDICAL COLLEGE &
HOSPITAL

4. INTRODUCTION
• Appendicitis is the most common intra-abdominal condition requiring emergency surgery, with a lifetime risk of 6%.1
• Appendicectomy continues to be one of the commonest procedures in general surgery, accounts for approximately 1%
of all surgical operation. Even though modern diagnostic facilities, surgery skills, fluids and antibiotic therapy have
brought down the mortality from 50% (before 1925) to less then 1/1,00,000persons, still the morbidity is more than 5-
8%, mainlydue to wound infection because of delayed diagnosis and treatment.
• Laparoscopic appendicectomy combines the advantages of diagnosis and treatment in one procedure with least
morbidity. Patients are likely to have less postoperative pain and to be discharged from hospital and return to activities
of daily living sooner than those who have undergone open
• The other advantages include decreased wound infection, better cosmesis, ability to explore the entire peritoneal cavity
for diagnosis of other conditions and effective peritoneal toileting without the need for extending the incision.
• The laparoscopic appendicectomy is increasingly employed, particularly in young women of child bearing age in whom
the differential diagnosis of right lower quadrant pain is extensive and includes gynecologic pathology.
• The modern era of laparoscopic surgery has evoked remarkable changes in approaches to surgical diseases.
• That trend towards minimally invasive surgery has prompted general surgeons to scrutinize nearly all operations per
possible conversion to laparoscopic techniques

5. OBJECTIVE
• Laparoscopic procedure for appendicectomy is compared with open surgical technique with respect to
• * Duration of surgery*
• Post operative pain and duration of analgesic,*
• Post operative Complications like vomiting, ileus, intraabdominal abscess and wound infection,*
• Post operative length of hospital stay,*
• Time taken to return to resume routine work

6. METHODOLOGY
• STUDY SETTING: DEPARTMENT OF GENERAL SURGERY- OPD/IPD
• STUDY DURATION: 12 MONTHS
• STUDY DESIGN: PROSPECTIVE COMPARATIVE STUDY
• SAMPLE SIZE: 100
• THE STUDY WILL BE STARTED AFTER RECEIVING
• 1) Institutional ethical committee approval
• 2) Written and informed consent from all patients included in the study

7. INCLUSION CRITERIA
• Inclusion: All patients of Acute or recurrent appendicitis.
of both genders.
Patients given written informed consent

8. EXCLUSION CRITERIA
• Patients with
 Children <10 yrs,
 pregnancy,
 Complications,
are excluded from the study population.

9. PROCEDURE
A patient will be included in the study once the inclusion & exclusion
criteria are met.
Informed written consent will be taken from all subjects.
Patient particulars will be noted.
The intraoperative and postoperative findings like duration of surgery,
healing of the wound, postoperative pain and stay in hospital are noted
during the intraoperative and postoperative period.
The patients are asked to follow-up upto 1 month after surgery to check
The results will be compared using student’s t test and chi square test and
analyzed.

10. PROFORMA
• NAME:
• I.P. NO/O.P. NO:
• AGE/ SEX:
• DOA:
• DOS:
• DOD:
• ADDRESS:
• CONTACT NUMBER:
• CONSENT OBTAINED: YES / NO
•

11. •HISTORY :
CHIEF COMPLAINTS
ABDOMINAL PAIN
FEVER
VOMITING
PAST HISTORY :
DM/STN/CAD/ASTHMA
PAST SURGICAL HISTORY:

12. Yes no
SMOKING
ALCOHOL
OTHERS
ADDICTIONS:
GENERAL EXAMINATION :
VITALS :
LOCAL EXAMINATION :
RADIOLOGICAL MODALITY USED

13. REFERENCES
• Naraintran S, David SKS, Raveendran K, Pilla BKE. Int Surg J 2018;5:1240–5.
• Other cited works: Guller (2004), Marzouk (2003), Ortega (1995), Moberg (2005) etc.

14. THANK YOU