Two-port Laparoscopic-assisted Appendicectomy Under Local Anesthesia in Adults: A Pilot Study

Aim: Nowadays laparoscopic-assisted appendicectomy using the two-port technique is gaining popularity due to its certain benefits over the open version. General anesthesia with positive pressure ventilation is the preferred mode of anesthesia in this technique. We conducted a pilot study using the two-port technique in adult patients, with uncomplicated appendicitis under local anesthesia, to evaluate its feasibility. Materials and Methods: In this prospective study 12 consecutive patients of ASA grade I and II, with a mean age of 22.5 years, suffering from acute appendicitis, were included. All the patients received ondansetron, diazepam, and pentazocine as premedication. Monitored anesthesia care was given. The site of trocar insertions were infiltrated with 1% lignocaine with adrenalin. The pneumoperitoneum was created using carbon-di-oxide. After exteriorization of the appendix using the trocar, appendicectomy was performed as in the open procedure. Results: Eleven out of twelve patients were successfully operated using this method without converting it into an open method. Two cases required an extra port to free the appendix from the adhesion. There were no intra- or post-operative complications present. Conclusion: Two-port laparoscopic-assisted appendicectomy under local anesthesia is a safe and effective method for uncomplicated appendicitis in adults, and the procedure is suitable where limited set-up for anesthesia is present.