Two Port Needle Assisted Appendicectomy (TPNAA)

Background: Laparoscopic appendicectomy has become the preferred procedure for treating appendicitis in last 10-15 years. The reasons are laparoscopy provides a better visualization of the operating field, pelvic organs like ovaries can be visualized in female patients, causes less postoperative pain, needs lesser hospital stay, gives faster recovery and most importantly a better cosmetic scar. The standard laparoscopic appendicectomy needs 3 ports to be introduced into the abdomen. Many modifications were introduced recently like SILS (Single port/Incision Laparoscopic Surgery), NOTES (Natural Orifice Transluminal Endoscopic Surgery), TUSPLA (Trans Umbilical Single Port Laparoscopic Appendicectomy), etc. with an intention to decrease the postoperative pain, decrease the hospital stay and give better cosmetic outcome. We present a series of twelve cases of laparoscopic appendicectomy performed using two ports and a needle instead of third port, which when performed successfully gives a better cosmetic outcome as the third port is avoided. Aims and objectives: The aim of the study was to assess the feasibility of two ports needle assisted laparoscopic appendicectomy. Materials and methods: This was an observational study done on a total number of 42 laparoscopic appendicectomies performed by a single operating team between June 2015 and May 2016. Two port appendicectomy were attempted. But, the procedure could be successfully performed in only 12 cases because of various reasons. Results: Out of 42 cases TPNAA could be performed successfully in 12 procedures. 30 cases needed regular 3 port procedure because of various reasons. Conclusion: TPNAA is a modification of regular three port appendicectomy and is a simple procedure and gives a better cosmetic outcome which can be performed in selected cases.