Comparison of Classical Open Appendectomy, Small Incision Appendectomy and Laparoscopic Appendectomy in Children with Uncomplicated Acute Appendicitis


  • Sheikh Imran Gul1, Asim Rafiq Laharwal2 , Ajaz Ahmad Wani1 , Arshad Rashid2



Appendectomy; Laparoscopic; Grid Iron; Small Incision; Children.


Background: The surgical anatomy of appendix coupled with a lax abdominal wall in children creates a

possibility of accomplishing an appendectomy using a small incision. The aim of the present study was to

compare the outcomes of classical grid iron, small incision and laparoscopic appendectomy in children with

uncomplicated acute appendicitis.

Method: A prospective comparative study was undertaken at a tertiary care hospital, where patients who

underwent either open (classical or small incision) or laparoscopic appendicectomy were studied and

compared for various intraoperative and postoperative parameters. The subjects selected for study were

children in the age group of 4 – 14 years of age, and were diagnosed as having simple acute appendicitis.

Results: Out of a total of 201 patients included in the study; 78 underwent appendectomy by classical Grid

iron incision, 62 by small incision and 67 by a conventional laparoscopic method. The baseline parameters

were similar in all the three groups. The mean operative time was significantly lower in small incision group.

There was no intra-operative complication noticed in any of the groups. Conversions were significantly

higher in the small incision group as compared to classical grid iron and laparoscopic approach. The mean

pain scores (visual analogue scale) were significantly decreased in the laparoscopic group. The mean hospital

stay and return to activities of daily life was significantly increased in the classical grid iron group.

Conclusion: Laparoscopic approach for appendectomy seems to be a clear winner in uncomplicated

paediatric appendicitis, but small incision approach provides an acceptable alternative, as compared to the

standard grid iron incision.

Author Biography

Sheikh Imran Gul1, Asim Rafiq Laharwal2 , Ajaz Ahmad Wani1 , Arshad Rashid2

1 Surgeon Specialist, Health Services Kashmir, (Current Affiliation), Post-graduate Scholar & Registrar,

Department of General Surgery, GMC Srinaga, (At the time of study), 2 Lecturer, Department of Surgery,

Government Medical College & Associated Hospitals, Srinagar