Description

Appendicectomy is one of the most common emergency surgical procedures performed worldwide. With advancements in minimally invasive surgery, laparoscopic appendicectomy has become the gold standard due to reduced postoperative pain, faster recovery, and better cosmetic results. Traditionally, laparoscopic appendicectomy requires three ports; however, with evolving surgical techniques and specialized instruments, a two-port laparoscopic appendicectomy has emerged as a safe and efficient alternative. Technique Overview The two-port laparoscopic appendicectomy involves the use of only two small incisions: one for the camera and another for the working instrument. This approach minimizes tissue trauma, reduces postoperative pain, and improves cosmetic outcomes. A critical tool in this procedure is the Stryker Mini Alligator, a specially designed laparoscopic instrument. Its unique design, with a narrow, articulating jaw, allows precise grasping and dissection in confined spaces, making it ideal for handling the appendix with minimal manipulation of surrounding tissues. Procedure Steps Patient Positioning: The patient is placed in a supine position with slight Trendelenburg tilt and left tilt to facilitate exposure of the appendix. Port Placement: Umbilical Port (10mm) for the camera. Suprapubic or right lower quadrant Port (5mm) for the Stryker Mini Alligator. Exploration and Identification: The laparoscope is inserted, and the appendix is identified. Adhesions, if present, are gently dissected using the Mini Alligator. Appendiceal Mobilization: The Mini Alligator allows precise grasping, traction, and dissection, reducing the risk of injury to adjacent bowel or mesoappendix. Ligation and Division: The base of the appendix is secured using endoloops or staplers, and the appendix is divided. Specimen Retrieval: The appendix is retrieved through the umbilical port using an endoscopic bag. Closure: Ports are removed, and the incisions are closed with absorbable sutures. Advantages of Two-Port Technique with Stryker Mini Alligator Minimally invasive: Only two small incisions, leading to less pain and faster recovery. Enhanced precision: The articulating tip of the Mini Alligator allows delicate handling of the appendix and mesoappendix. Reduced complications: Limited tissue trauma and precise dissection reduce the risk of postoperative adhesions or infection. Cosmetic benefits: Smaller incisions improve postoperative cosmesis. Cost-effective: Reduced port usage may lower operative costs in select cases. Conclusion The two-port laparoscopic appendicectomy using the Stryker Mini Alligator is a safe, efficient, and cosmetically favorable approach to appendectomy. With proper training and careful patient selection, this technique can provide excellent surgical outcomes while maintaining the principles of minimally invasive surgery.