Appendicitis: laparoscopic versus conventional operation: a study and review of the literature

A retrospective study was performed after introduction of the laparoscopic technique in patients with suspected appendicitis to validate it in comparison with conventional open appendectomy. A series of 103 patients with suspected acute appendicitis were included. In 51 consecutive patients, a diagnostic laparoscopy was performed, and, if needed, an appendectomy was carried out. Fifty-two consecutive patients underwent conventional appendectomy. The primary intention of the laparoscopy was diagnostic, but if the patient was found to suffer from appendicitis, a laparoscopic appendectomy was performed. Eight (16%) patients in the laparoscopic group had a healthy appendix that was left in place. Eleven (22%) patients in this group were converted to open appendectomy. There was no significant difference between the groups concerning age, sex, or diagnosis at the time of the operation, and there was also no significant difference in the postoperative hospital stay or complication rate between the groups. The postoperative need for analgesia was lower (p < 0.01) and the operation time was longer (p < 0.0001) in the laparoscopic group than the group that underwent open surgery. It can be concluded that the greatest benefits of the laparoscopic technique are that it causes less trauma, the diagnostic accuracy is better, and the cosmetic result is superior to that after a conventional operation. This is all at the price of a longer operation time.