Can Two-Port Hand Assisted Laparoscopic Appendectomy be a Good Alternative to Open and Three Port Appendectomies?

Aim: Laparoscopic appendectomy has been performed in increasing numbers since it was first described in 1980. Nowadays, it is being performed by using the three-, two-and single-port methods. We performed two-port hand-assisted laparoscopic appendectomies and reported our prospective results. Methods: Forty consecutive patients (27 males and 13 females) with acute appendicitis according to physical examination and ultrasonography findings were operated on with two-port hand-assisted laparoscopic appendectomy by the same surgeon between 2011 and 2015. Five-mm (subumbilical) trocar for endoscopy and 10-mm (McBurney) trocar were used to perform appendectomy. The appendix was taken out through the lumen of the 10-mm trocar and ligated extracorporeally and appendectomy was completed extracorporeally. If necessary, another 5-mm trocar was also placed at the left lower quadrant in difficult cases and appendectomy was completed in the same way as described. Results: The mean duration of the surgical procedure was 23.175 minutes and the mean duration of the whole operation was 41.3 minutes. All the patients except for one were discharged on the first postoperative day. A third port was necessary in 8 (8/40) cases. The mean hospitalization time was 1.075 days. Conclusion: The two-port hand-assisted laparoscopic technique combines both the advantages of open and laparoscopic surgeries, providing a shorter operation time and hospital stay. In difficult cases, one should not hesitate to insert a third 5-mm port and complete the assisted appendectomy.