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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 2000 Nov;82(6):388–391.

Laparoscopic appendicectomy: safe and useful for training.

S E Duff 1, A R Dixon 1
PMCID: PMC2503470  PMID: 11103154

Abstract

Debate exists about the benefits of laparoscopic appendicectomy when compared to a conventional open procedure. The majority of appendices are removed by the open route in the UK. We report a series of 132 cases of suspected appendicitis managed laparoscopically: 112 (85%) of the patients had acute appendicitis, the remaining 20 (15%) had non-appendiceal pathology. The median operative time was 30 min and there were no conversions to an open operative procedure. The median postoperative stay was two days. Complications were seen in two patients. The published evidence comparing laparoscopic and open appendicectomy is contradictory. Our series shows that laparoscopic appendicectomy is a safe procedure with low morbidity; it is also an excellent training tool in laparoscopic technique and, with sufficient experience, takes no longer than an open procedure. Negative appendicocecotomies are most common in women of fertile age and can be associated with significant morbidity; therefore, laparoscopy should be used to make the diagnosis and, if appendicitis is the cause, the appendix could safely be removed laparoscopically. However, the choice between open and laparoscopic procedure is a subjective decision for the patient and their surgeon. Laparoscopic appendicectomy cannot be regarded as the gold standard.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Attwood S. E., Hill A. D., Murphy P. G., Thornton J., Stephens R. B. A prospective randomized trial of laparoscopic versus open appendectomy. Surgery. 1992 Sep;112(3):497–501. [PubMed] [Google Scholar]
  2. Baigrie R. J., Dehn T. C., Fowler S. M., Dunn D. C. Analysis of 8651 appendicectomies in England and Wales during 1992. Br J Surg. 1995 Jul;82(7):933–933. doi: 10.1002/bjs.1800820726. [DOI] [PubMed] [Google Scholar]
  3. Berry J., Jr, Malt R. A. Appendicitis near its centenary. Ann Surg. 1984 Nov;200(5):567–575. doi: 10.1097/00000658-198411000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Frazee R. C., Roberts J. W., Symmonds R. E., Snyder S. K., Hendricks J. C., Smith R. W., Custer M. D., 3rd, Harrison J. B. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg. 1994 Jun;219(6):725–731. doi: 10.1097/00000658-199406000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Grabham J. A., Sutton C., Nicholson M. L. A case for the removal of the 'normal' appendix at laparoscopy for suspected acute appendicitis. Ann R Coll Surg Engl. 1999 Jul;81(4):279–280. [PMC free article] [PubMed] [Google Scholar]
  6. Hansen J. B., Smithers B. M., Schache D., Wall D. R., Miller B. J., Menzies B. L. Laparoscopic versus open appendectomy: prospective randomized trial. World J Surg. 1996 Jan;20(1):17–21. doi: 10.1007/s002689900003. [DOI] [PubMed] [Google Scholar]
  7. Heinzelmann M., Simmen H. P., Cummins A. S., Largiadèr F. Is laparoscopic appendectomy the new 'gold standard'? Arch Surg. 1995 Jul;130(7):782–785. doi: 10.1001/archsurg.1995.01430070104022. [DOI] [PubMed] [Google Scholar]
  8. Hellberg A., Rudberg C., Kullman E., Enochsson L., Fenyö G., Graffner H., Hallerbäck B., Johansson B., Anderberg B., Wenner J. Prospective randomized multicentre study of laparoscopic versus open appendicectomy. Br J Surg. 1999 Jan;86(1):48–53. doi: 10.1046/j.1365-2168.1999.00971.x. [DOI] [PubMed] [Google Scholar]
  9. Klingler A., Henle K. P., Beller S., Rechner J., Zerz A., Wetscher G. J., Szinicz G. Laparoscopic appendectomy does not change the incidence of postoperative infectious complications. Am J Surg. 1998 Mar;175(3):232–235. doi: 10.1016/s0002-9610(97)00286-9. [DOI] [PubMed] [Google Scholar]
  10. Laine S., Rantala A., Gullichsen R., Ovaska J. Laparoscopic appendectomy-is it worthwhile? A prospective, randomized study in young women. Surg Endosc. 1997 Feb;11(2):95–97. doi: 10.1007/s004649900305. [DOI] [PubMed] [Google Scholar]
  11. Lau W. Y., Fan S. T., Yiu T. F., Chu K. W., Wong S. H. Negative findings at appendectomy. Am J Surg. 1984 Sep;148(3):375–378. doi: 10.1016/0002-9610(84)90475-6. [DOI] [PubMed] [Google Scholar]
  12. McAnena O. J., Austin O., O'Connell P. R., Hederman W. P., Gorey T. F., Fitzpatrick J. Laparoscopic versus open appendicectomy: a prospective evaluation. Br J Surg. 1992 Aug;79(8):818–820. doi: 10.1002/bjs.1800790837. [DOI] [PubMed] [Google Scholar]
  13. Moberg A. C., Montgomery A. Appendicitis: laparoscopic versus conventional operation: a study and review of the literature. Surg Laparosc Endosc. 1997 Dec;7(6):459–463. [PubMed] [Google Scholar]
  14. Pier A., Götz F., Bacher C., Ibald R. Laparoscopic appendectomy. World J Surg. 1993 Jan-Feb;17(1):29–33. doi: 10.1007/BF01655701. [DOI] [PubMed] [Google Scholar]
  15. Pier A., Götz F., Bacher C. Laparoscopic appendectomy in 625 cases: from innovation to routine. Surg Laparosc Endosc. 1991 Mar;1(1):8–13. [PubMed] [Google Scholar]
  16. Tate J. J., Dawson J. W., Chung S. C., Lau W. Y., Li A. K. Laparoscopic versus open appendicectomy: prospective randomised trial. Lancet. 1993 Sep 11;342(8872):633–637. doi: 10.1016/0140-6736(93)91757-d. [DOI] [PubMed] [Google Scholar]
  17. Vallina V. L., Velasco J. M., McCulloch C. S. Laparoscopic versus conventional appendectomy. Ann Surg. 1993 Nov;218(5):685–692. doi: 10.1097/00000658-199321850-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]

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