AUDIT OF LAPAROSCOPIC APPENDICECTOMY IN A SURGICAL UNIT.

Abstract

Background With the advent of laparoscopy, surgeons need new skills and must relearn the procedures that had been familiar in open surgery. For some procedures, like appendicectomy, the learning curve can be steep, owing to the diversity of clinical presentations and the different locations of the appendix. Laparoscopic appendicectomy is gaining momentum worldwide because of the purported benefits of minimal access. The implication is that surgical training needs to adjust accordingly to provide adequate skills to prospective surgeons. In this manuscript, we endeavor to review the practice of laparoscopic appendicectomy in our unit. Objective A two-year review of laparoscopic appendicectomy in a surgical unit to reflect on the stages of appendicitis at presentation, the percentage of procedures done laparoscopically, and the trainees’ contributions. Method Retrospective analysis of data prospectively collected between January 2013 and December 2014 in a surgical unit at the Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, South Africa. The parameters analyzed included patient demographics, surgical approach, intraoperative findings, and histopathological reports. Results The male to female ratio was 2:1, with a mean age of 25.7 years. The percentages of complicated, uncomplicated, and normal appendices, based on histopathological reports, were 53%, 20%, and 12%, respectively. Conclusion The laparoscopic approach represented 63% of all appendicectomies. More than half of the cases of appendicitis were complicated. Specialist surgeons performed most of the laparoscopic cases.