Should an Interval Appendicectomy Be Performed by a Minimally Invasive Gynaecologist?

Area of Science:

• Gynaecological Surgery
• Surgical Pathology
• Minimally Invasive Procedures

Background:

• Intraoperative identification of abnormal appendix during benign gynaecological surgery presents diagnostic and management challenges.
• The role of gynaecological specialists in appendicectomy for non-gynaecological indications remains under-explored.

Purpose of the Study:

• To investigate the pathological findings of appendix specimens removed during elective benign gynaecological surgery due to intraoperative abnormal appearance.
• To assess the complication rate associated with appendicectomy performed by minimally invasive gynaecologists in these specific cases.

Main Methods:

• Retrospective cohort study (2004-2023) at a tertiary referral center.
• Included 34 women undergoing laparoscopic surgery for benign gynaecological conditions with intraoperative appendicectomy.
• Data collected on demographics, clinical presentation, surgical details, pathology, and postoperative complications.

Main Results:

• Appendicectomy indications included appendiceal immobility (38.2%), adhesions (41.2%), and abnormal appearance (20.6%).
• Pathology revealed acute/chronic appendicitis (17.6%), endometriosis (11.8%), other abnormalities (14.7%), and cancer (8.8%).
• The postoperative complication rate was 5.8% (2 cases).

Conclusions:

• Appendicectomy by trained gynaecological specialists is supported when abnormal appendix findings are encountered during elective gynaecological surgery.
• This practice can reveal significant pathology, including malignancy.
• Further research and guidelines are recommended to refine gynaecological surgical practice.