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Appendectomy in Switzerland: how is it done?
Nicolas M Obrist1, Christoph Tschuor1, Stefan Breitenstein1
1Department of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
Updates in Surgery
|April 15, 2019
Summary
Most Swiss surgeons prefer laparoscopic appendectomies, utilizing endoloops or staplers for stump closure. Routine abdominal lavage and stump plunging are uncommon in appendicitis treatment strategies.
Area of Science:
- Surgical Procedures
- Gastrointestinal Surgery
- Medical Technology
Background:
- Appendicitis is a common surgical emergency in Switzerland, with over 10,000 appendectomies annually.
- Laparoscopic appendectomy is increasingly the standard of care, but variations in technique exist.
Purpose of the Study:
- To survey Swiss surgeons regarding their appendicitis treatment strategies.
- To investigate preferences for laparoscopic techniques, stump closure methods, and abdominal lavage.
- To identify differences in approaches for adult vs. pediatric and complicated vs. uncomplicated appendicitis.
Main Methods:
- Anonymous survey distributed to 540 members of the Swiss Surgical Society.
- Investigated technical details of appendectomy, including laparoscopic approach, stump closure, and lavage.
- Data analyzed based on patient age and appendicitis complexity.
Main Results:
- High adoption of laparoscopic appendectomy: 78% in children, 95% in adults.
- Staplers are preferred for stump closure in complicated appendicitis (82%), while endoloops (41%) and staplers (36%) are common in uncomplicated cases.
- Most surgeons (76%) do not plunge the appendiceal stump; routine abdominal lavage with >1L fluid is performed by 24%.
Conclusions:
- Swiss surgeons predominantly use multiport laparoscopic appendectomy.
- Staplers are the preferred method for stump closure in complicated appendicitis.
- Plunging the stump and routine extensive abdominal lavage are not widely practiced.
