DOI: 10.36347/sjams.2019.v07i06.021

Pages: 2139-2143

AIM: To show modified port positions in laparoscopic appendicectomy which provides surgical advantages and better cosmesis. Materials and method: Laparoscopic appendicectomy with these modified port positions was successfully performed in 378 cases over a nine years and eight months period from July 2009 to February 2019. First 12 mm port is placed on the lower margin of umbilicus. Next 5mm port is placed in the suprapubic midline below the pubic hairline. Third 5mm port is placed in the midline between the two previous ports. If the appendicectomy is expected to be an easy one, the third 5mm port is replaced by a 2.5mm alligator (instrument) port to hold and lift the appendix. Whenever necessary a 5mm telescope was used from any of the 5mm ports. Results and observation: A total of 226 post appendicular lumps & recurrent appendicites with recurrent right lower abdominal pain and 152 acute appendicitis including 33 cases of appendicular perforation with generalized peritonitis were operated. Bowel walking was performed in all the recurrent appendicites cases. Ovarian cystectomies, drainage of fallopian tube abscess, excision of fimbrial cyst, extensive adhesiolysis and omental & lymph node biopsy were also performed in few cases along with the appendicectomy. All patients were very highly satisfied with their postoperative scar. Conclusion: Laparoscopic approach using three infraumbilical midline ports gives a very good visualization, provides a very comfortable operating position for the surgeon & yields a better cosmetic scars. One can also deal with other pelvic pathology easily, without any extra port.