[Laparoscopic appendectomy as standard procedure. Technique and outcome in 409 patients]

In the framework of a prospective clinical trial we wanted to show that minimal access surgery as a standard treatment of acute appendicitis leads to good results.

From January 1993 to December 1996 409 patients had a laparoscopic appendectomy in the Surgical Department of Krankenhaus Zehlendorf, Berlin. We treated 252 female (62%) and 157 male (38%). The mean age was 31.5 years (min. 8 years, max. 81 years) The conversion rate was 8% (33 patients). Reasons for conversion were perforation or difficult anatomical conditions. In 189 patients we found additional diagnosis as adhesions, gynecological diseases or chronic inflammatory bowel diseases.

The clinical diagnosis sensitivity histological correlated was 83%. The mean operating time was 46 minutes (min. 10, max. 120 minutes). The basis of appendix was routinely carried by loop of catgut in 342 cases. In 23 cases was used the Endo-GIA. Severe postoperative complications were seen in 2%. In 1.3% planned second-look laparoscopy with drainage was performed. The patients stayed in hospital for 5 days in median (min. 1 day, max. 21 days). The rate of wound infections was decreased specially in fat patients.