Technical and social challenges of laparoscopic appendectomy performed in a rural setting.
OBJECTIVE
The current study reports technical and social details aiming to evaluate difficulties faced while performing laparoscopic appendectomy (LA) in a rural hospital as well as providing solutions.


METHODS
Patients who underwent LA with a diagnosis of acute appendicitis between April 2009 and December 2010 were included in this study. Demographic details, operative findings and postoperative outcomes were analyzed.


RESULTS
Fifty-one consecutive patients (28 male and 23 female) underwent LA. The median age was 23 years (range, 13-74); the median operative time was 45 minutes (range, 20-75). Appendiceal base securing was performed either endoloops in 4 (7.8%), or via intracorporeal knot tying in 46 (90.2%) patients and 1 was sutured. Complicated/technically difficult appendicitis was faced in 20 (39.2%) patients. One patient underwent conversion to open procedure (2%). Mean postoperative hospital stay was 2.4 ± 0.8 days. Postoperative intra-abdominal abscess occurred in 1 (2%) patient.


CONCLUSIONS
LA can be performed safely in a rural hospital, even for complicated cases. In this study, we have discussed some technical and social difficulties encountered and the solution methods adopted when performing LA in rural settings.
Gultekin Ozan
GO
Kucuk
D018784:Abdominal Abscess; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000009:adverse effects; D001064:Appendicitis / Q000601:surgery*; D001065:Appendix / Q000601:surgery; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult