Laparoscopic Vs Open Appendectomy: A Comparative Study of Operative Time, Complications, and Recovery

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies in India. Open appendectomy (OA) has been the standard procedure for decades, whereas laparoscopic appendectomy (LA) has gained popularity due to minimal invasiveness and faster recovery. With the advancement of minimally invasive techniques, laparoscopic appendectomy has increasingly been adopted as an alternative to the conventional open approach. However, differences in operative time, postoperative complications, and recovery outcomes remain areas of ongoing evaluation, particularly in tertiary care settings.

Aim: To compare laparoscopic and open appendectomy in terms of operative time, postoperative complications, and duration of recovery.

Material and Methods: This comparative observational study was conducted at a tertiary care hospital and included 84 patients diagnosed with acute appendicitis. Patients were divided into two equal groups: 42 underwent laparoscopic appendectomy (LA group) and 42 underwent open appendectomy (OA group). Demographic data, operative findings, and postoperative outcomes were recorded. Primary outcomes included operative time and complication rates. Secondary outcomes included postoperative pain assessed using the Visual Analog Scale (VAS), time to oral intake, time to return of bowel function, duration of hospital stay, and time to return to normal daily activities.

Results: The mean operative time was significantly longer in the LA group (52.36 ± 11.48 minutes) compared to the OA group (46.28 ± 9.62 minutes) (p = 0.011). Postoperative pain scores at 24 and 48 hours were significantly lower in the LA group (p < 0.001). Time to oral intake, return of bowel function, and hospital stay were significantly shorter in the LA group (p < 0.001). The overall complication rate was significantly lower in the LA group (16.67%) compared to the OA group (45.24%) (p = 0.006).

Conclusion: Laparoscopic appendectomy offers significant benefits in terms of reduced postoperative pain, faster recovery, shorter hospitalization, and lower overall complication rates, despite a slightly longer operative time. It represents a safe and effective alternative to open appendectomy in the management of acute appendicitis.