Laparoscopic Appendectomy: Outcomes of 10 mmHg Versus 15 mmHg Intra-abdominal Pressure

This prospective, randomized controlled trial aims to compare the clinical outcomes of laparoscopic appendectomy performed under two standard pneumoperitoneum pressures (10 mmHg and 15 mmHg). The primary objective is to evaluate postoperative pain, while secondary outcomes include operative time, conversion rate, time to first flatus and bowel movement, length of hospital stay, postoperative ileus, and intra-abdominal abscess formation. The study will determine whether lower-pressure pneumoperitoneum provides comparable surgical conditions while improving postoperative recovery.

Inclusion Criteria: * Age 18-60 years. * Clinical and/or radiological diagnosis of acute appendicitis. * Planned laparoscopic appendectomy(Uncomplicated acute appendicitis considered suitable for laparoscopic management). * ASA physical status I-III. * Written informed consent. Exclusion Criteria: * Age \60 years * Pregnancy * Appendiceal mass or suspected appendiceal malignancy * Diffuse peritonitis requiring planned open surgery * Severe cardiopulmonary disease in whom pneumoperitoneum pressure cannot be standardized * Previous extensive abdominal surgery causing expected severe adhesions * Patients requiring additional major abdominal procedure * Missing consent * Incomplete postoperative follow-up * Patients managed non-operatively without surgery