Comparative Trial of Periumbilical Incision versus Intraumbilical Incision in Emergency Laparoscopic Appendectomy in a High Volume Laparoscopic Surgery Centre

Abstract

Background and Objective: An appendectomy is the surgical removal of the vermiform appendix. Laparoscopic Appendectomy is increasingly performed these days. Direct studies on comparison of complication
rates of periumbilical and intraumbilical incision are lacking. The objective was to compare the frequency of
infective complications of two different types of laparoscopic appendectomy incisions i.e. periumbilical
incision versus intraumbilical.
Methods: This retrospective study was carried out at Department of Surgery, Our Lady of Lourdes Hospital,
Drogheda, Ireland for 6 months (From 27.05.2015 to 26.11.2015). Medical records of 1044 patients who had
LaparoscopicAppendectomy from 2010 to 2014 were analyzed. Their Preoperative, intraoperative, Postoperative
and clinical notes were reviewed. This included patients who underwent laparoscopic appendectomy with
periumbilical incision technique and those who were operated with intraumbilical incision technique. All the
data were analyzed using computer software SPSS version 21.
Results: The mean age of the patients was 40.38±11.76 years. Ratio of Male to female was 1.6:1.The erythema
was observed in 31.42% patients, edema was present in 242(23.2%), pain was present in 278(26.6%) and the
purulent discharge was noted in 294(28.2%) patients. Overall wound infection was found in 16.86% patients.
In intra umbilical group wound infection was found in 7.28% of patients while this rate was 26.44% in peri
umbilical group. Statistically significant difference was found between the study groups i.e. p-value<0.001.
Conclusion: Intraumbilical incision is a safer and feasible substititute for the periumbilical incision, and it
promises better outcomes.
KEYWORDS: Intraumbilical, Periumbilical, Incision, Laparoscopy, Infection, Appendectomy, Appendicitis,
Open surgery.