[Endoscopic surgical technique in appendectomy. Experiences and results of 950 laparoscopic appendectomies]

In a prospective study 950 appendectomies were done consecutively from May 1992 to September 1997. When indication for appendectomy was given all patients were operated on endoscopically. In 5.5% of cases had to be turned to open operation. 17 different surgeons are involved. Even the first appendectomy in adjucation of young residents was done endoscopically. 372 (39.15%) male and 578 (60.85%) female patients were operated. Average age was 25.3 years (4 to 84 years). In 11% of cases so-called chronic recurrent appenditicis as indication was accepted only after careful exclusion of other reasons for complaint. Mean duration of operation time was 44.5 min (15 to 170 min). Hospital stay was influenced subjectively 6.1 day (1 to 19 days). Examination of specimen by the pathologist shows following results: perforated appendicitis 7%; acute appendicitis 50%; chronic recurrent 33%; no pathologic changes 9%; carcinoide or oxyures 1%. The Postoperative complication rate was very small: only 2.7% (relaparotomy because of small bowel obstruction: 4, paracolic abscess after severe phlegmonic inflammation: 4, infected haematomas: 2, relaparotomy because of unobserved deverticula of Meckel with severe inflammation: 1, delayed woundhealing: 8, postoperative pain with duration long than: 24 hours: 7).