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[Laparoscopic appendectomy. State of the art]
Ferdinando Agresta1, Paolo De Simone, Natalino Bedin
1U.O. di Chirurgia Generale Ospedale Civile, Vittorio Veneto, TV.
Chirurgia Italiana
|June 1, 2002
Summary
Laparoscopic appendectomy is increasingly used, yet adoption varies. Surgeons often reserve this minimally invasive approach for specific cases, particularly in women, and its diagnostic capability influences imaging use.
Area of Science:
- Minimally Invasive Surgery
- Gastrointestinal Surgery
- Surgical Oncology
Background:
- Laparoscopic appendectomy has seen increasing adoption for acute appendicitis.
- Data on current practices and outcomes in North-Eastern Italy were previously limited.
Purpose of the Study:
- To survey the state of the art of laparoscopic appendectomy in North-Eastern Italy.
- To evaluate the adoption rates, indications, and outcomes of this procedure.
Main Methods:
- A fact-finding survey was conducted among surgeons in North-Eastern Italy.
- Data were collected on laparoscopic procedures performed between 1991 and 2000.
- Information gathered included adoption rates, patient selection, conversion rates, complications, and hospital stay.
Main Results:
- 10,451 laparoscopic appendectomies were performed from 1991-2000.
- Only 58% of surgeons routinely used laparoscopy for suspected appendicitis; 36% used it for all patients, 60% reserved it for females.
- Mean conversion rate was 4.9%, major intraoperative complications 0.08%, major postoperative morbidity 0.6%, and wound infections 2%. Mean hospital stay was 3 days.
Conclusions:
- Laparoscopic appendectomy adoption is not universal despite its benefits.
- The high diagnostic yield of laparoscopy may reduce reliance on preoperative imaging.
- Surgeons often remove the appendix even without macroscopic inflammation and convert for suspected neoplasia.