Computed tomography scan-guided preoperative identification of the appendicular root as an indicator of the best skin incision site in open appendicectomy: a retrospective single-center study.

Abstract

Background: Appendicectomy is a well-established surgical procedure used for managing of acute appendicitis. In open appendicectomy, McBurney's point is the surgical landmark for locating the appendix, and it is common practice to make an incision there. However, in this study, we identified the root of the appendix via computed tomography, made an incision around that sites, and performed the appendicectomy through this incision. As such, this study aimed to assess the safety and outcomes of using the computed tomography scan-guided appendiceal root as a landmark of the incision site in open appendicectomy.

Methods: This retrospective single-center study included 117 consecutive patients undergoing surgery for acute appendicitis between April 2021 and December 2023. Patients with parabdominal rectus muscle incision and interval appendectomy were excluded. The root of the appendix was identified on computed tomography scan, and open appendicectomy was performed via an oblique incision made at the center of the site. The characteristics and perioperative factors of patients who underwent open appendicectomy and laparoscopic appendicectomy were compared.

Results: None of the patients required a change or widening of the incision site to identify the appendix, and there were no complications associated with using this site. The median wound size for open appendicectomy was 4 cm. Patients who underwent open appendicectomy performed comparable to those who underwent laparoscopic appendicectomy.

Conclusion: Using the computed tomography scan-guided appendiceal root as a landmark for the site of skin incision in appendicectomy is safe, acceptable, and useful.