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Background The aim of this study was to validate the pros of laparoscopic appendectomy (LA) over open appendectomy (OA) and to compare various primary outcome measures in the management of acute and recurrent appendicitis. Study Design Prospective comparative study. Place and Duration Between June 2015 and October 2019 in JJ Hospital, Mumbai. Materials and Methods Total of 60 patients with acute and recurrent appendicitis were included in the study. Thirty patients underwent OA and 30 underwent LA. Both groups were comparable clinicopathologically and demographically. Various intraoperative and postoperative parameters were compared. Continuous variables were expressed as mean ± standard deviation and categorical variables were expressed as percentages. Mann-Whitney U test was used to compare continuous variables and chi-squared test was used to compare categorical variables. p -Value≤0.001 was considered to be statistically significant. Results The median age of patients undergoing OA and LA was 24.9 and 25.2 years ( p = 0.221), respectively. Female: male ratio in OA and LA was 1.30 and 1.14, respectively ( p = 0.795). Mean operative duration in LA and OA group was 47.17 ± 14.39 minutes and 36.9 ± 12.33 minutes ( p = 0.001), respectively. Mean length of postoperative stay in LA and OA group was 3.69 ± 0.71 days and 5.28 ± 0.63 days ( p = 0.000), respectively. Median visual analogue scale score in LA and OA group was 3.5 and 5 ( p = 0.001), respectively. Mean time to return to normal activity in LA and OA group was 8.13 ± 1.33 days and 10.10 ± 2.20 days ( p = 0.000), respectively. About 6.66% patients in LA group and 13.33% in OA group had postoperative wound infection ( p = 0.652). Mean scar scale scoring done on 30th postoperative day was 4.23 in LA and 8.23 in OA ( p = 0.000). Discussion and Conclusion LA is more promising than OA in the management of acute and recurrent appendicitis. LA offers lesser operative site pain in the postoperative period, shorter postoperative hospital stays, earlier recovery, and return to normal activities and cosmetically better scars on 30th day follow-up. No conversions or significant difference in wound related complications were seen in both groups. Prolonged intraoperative duration was the only drawback of LA.
RESUMO
Wearable exoskeletons show promise as a means for compensating lost function as well as for providing optimal assistance for maximal therapeutic benefit during everyday tasks. Development of lightweight spring systems for efficient storage and return are proposed as a key component in the successful deployment of wearable exoskeletons for individuals with neurological deficits. Both spring steel and natural rubber are common materials used in energy storage, but have not been directly compared by metrics such as energy storage density, energy storage efficiency, and hysteresis. In this work, we perform cyclic loading tests on spring steel extension springs of varying wire diameter and natural rubber tubing of varying wall thicknesses. We then use measured load-extension profiles to illustrate and compute metrics to better quantify the energy storing capabilities of each material and their appropriateness for use as energy storing and returning components in wearable robotic applications. Results show that natural rubber has a higher capacity for energy storage per unit weight in comparison to steel springs. Hysteresis is also higher in natural rubber and can be dramatically reduced by applying adequate pre-strain at levels greater than the anticipated strain during use.
