Related Experiment Videos
[Can we recognize the pathological character of the appendix during laparoscopy? Prospective study: 81 cases]
1Service de Chirurgie Générale et Digestive, Université Paris XIII, UFR de Médecine de Bobigny-Bondy, Hôpital Jean Verdier, Bondy.
Journal De Chirurgie
|November 1, 1996
Summary
Surgeons accurately identified acute appendicitis during laparoscopy. Leaving a visually normal appendix in place, with antibiotics, poses a low risk of missed early appendicitis.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Laparoscopic surgery is common for right iliac fossa pain.
- Accurate diagnosis of appendicitis during laparoscopy is crucial.
Purpose of the Study:
- To evaluate the accuracy of visual assessment of the appendix during laparoscopy.
- To determine the safety of not removing a visually normal appendix.
Main Methods:
- Prospective study of 81 patients undergoing laparoscopy for right iliac fossa pain.
- Appendix photographed during surgery; evaluated by 10 surgeons.
- Visual assessment compared with histopathological findings.
Main Results:
- Acute appendicitis diagnosed in 60% of surgically removed appendices.
- Surgeons correctly identified all cases of acute appendicitis.
- Visual assessment accuracy for normal appendix was 70%.
- Maximum risk of missing early appendicitis was 14%.
Conclusions:
- Visual assessment of the appendix during laparoscopy is highly accurate for acute appendicitis.
- Not removing a visually normal appendix is a safe strategy.
- Antibiotics can mitigate the low risk of developing early appendicitis.