Description

Laparoscopic appendicectomy has become the gold standard in the surgical management of acute and chronic appendicitis. With the advancement of high-definition (HD) imaging and refined minimally invasive techniques, surgeons are now able to perform the procedure with fewer ports while maintaining safety, precision, and cosmetic benefits. The two-port high-definition laparoscopic appendicectomy is one such innovative approach that combines efficiency with superior visualization. Introduction The appendix, when inflamed, requires prompt surgical removal. Traditional open surgery, though effective, is associated with larger incisions, increased pain, and delayed recovery. Standard laparoscopic appendicectomy is usually performed with three ports. However, the two-port technique significantly reduces invasiveness while ensuring equivalent outcomes. When aided with HD laparoscopic systems, this approach offers magnified and crystal-clear visualization, allowing surgeons to operate with enhanced accuracy and confidence. Technique of Two-Port Laparoscopic Appendicectomy Patient Positioning Supine position with slight Trendelenburg tilt. Right side of the patient elevated to facilitate visualization of the appendix. Port Placement A 10 mm umbilical port is introduced for the laparoscope (HD camera). A 5 mm working port is placed in the suprapubic or left lower quadrant area, depending on surgeon preference. Visualization and Dissection Using a high-definition laparoscope, the appendix is clearly visualized with fine detail of the mesoappendix and surrounding structures. A grasper introduced through the working port assists in mobilizing the appendix. In some cases, the umbilical port allows simultaneous use of specialized instruments, minimizing the need for an additional port. Appendix Removal The mesoappendix is divided, and the appendix base is ligated using endoloops or stapling devices. The specimen is retrieved through the umbilical port. Closure Minimal port-site closure ensures excellent cosmetic outcomes with nearly invisible scars. Advantages of Two-Port HD Laparoscopic Appendicectomy Fewer Incisions: Reduced trauma to the abdominal wall compared to conventional three-port surgery. High-Definition Clarity: Superior visualization helps in safe dissection, identification of anatomical variations, and prevention of complications. Less Postoperative Pain: Fewer ports result in less pain and quicker mobilization. Cosmetic Benefit: Almost scarless surgery, especially appealing to young patients. Faster Recovery: Shorter hospital stay and early return to daily activities. Clinical Applications The two-port laparoscopic technique is suitable for: Uncomplicated acute appendicitis. Recurrent or chronic appendicitis. Selected pediatric and young adult cases. However, in complicated appendicitis (perforated or gangrenous), additional ports may be required for safe completion of surgery. Conclusion The high-definition two-port laparoscopic appendicectomy is a safe, effective, and patient-friendly technique. It offers the dual advantage of advanced imaging and minimally invasive access, resulting in excellent surgical outcomes. With growing expertise and availability of HD laparoscopic systems, this approach is emerging as a preferred alternative to conventional multi-port appendicectomy.