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Journal of Laparoendoscopic Surgery Dec 1992Laparoscopic appendectomy can easily be performed by a surgeon familiar with laparoscopic cholecystectomy. The technique described employs the same spatial relationships...
Laparoscopic appendectomy can easily be performed by a surgeon familiar with laparoscopic cholecystectomy. The technique described employs the same spatial relationships which are used in laparoscopic cholecystectomy. By maximizing the similarities between the two operations, surgeon and assistants can rapidly become comfortable with laparoscopic appendectomy. Of the laparoscopic appendectomies attempted 88% were successfully completed. The technique and results are presented and discussed.
Topics: Adolescent; Adult; Aged; Appendectomy; Appendicitis; Child; Humans; Laparoscopes; Laparoscopy; Ligation; Middle Aged; Suture Techniques
PubMed: 1490002
DOI: 10.1089/lps.1992.2.343 -
Minerva Medica Mar 1995The authors report their experience of 6 cases of appendicectomy using a laparoscopic route of which 5 were performed under local anesthesia and 1 under general... (Clinical Trial)
Clinical Trial
The authors report their experience of 6 cases of appendicectomy using a laparoscopic route of which 5 were performed under local anesthesia and 1 under general anesthesia. The results indicate that this new technique is easy to perform and as rapid and safe as the traditional operation. The possibility of using local anesthesia, the lack of complications when operating on obese patients, the lower incidence of wound infections and rapid postoperative mobilisation all argue in favour of this alternative approach to conventional open surgery.
Topics: Adolescent; Adult; Aged; Appendectomy; Female; Humans; Laparoscopy; Middle Aged
PubMed: 7603611
DOI: No ID Found -
International Journal of Colorectal... Jan 2013Although appendectomies are frequently performed and new procedural techniques have emerged, no nationwide analysis exists after the cessation of the German quality...
INTRODUCTION
Although appendectomies are frequently performed and new procedural techniques have emerged, no nationwide analysis exists after the cessation of the German quality control in 2004.
METHODS
One thousand eight hundred seventy surgical hospitals in Germany were asked to answer questions anonymously concerning the size of the department, applied procedural techniques, various technical details, as well as the approach to the intraoperative finding of an inconspicuous appendix.
RESULTS
We received 643 questionnaires (34.4 %) for evaluation. Almost all hospitals (95.5 %) offer laparoscopic appendectomy (LA), 15.4 % offer single-port (SPA), and 2.2 % (hybrid-) NOTES technique (NA). LA is the standard procedure in 85.2 % of male and in 89.1 % for female patients. In an open procedure (OA), the appendix and mesoappendix are mostly ligated (93.8 and 91.5 %). A Veress needle and open access are employed equally for LA. In 66.6 % of LA, the appendix is divided using an Endo-GIA, the mesoappendix in 45.5 % with bipolar coagulation. Almost half of the hospitals routinely flush the site in OA and LA. In open surgery with an inconspicuous appendix but a pathological finding elsewhere in the abdomen, it is resected "en principe" in 64.7 % and in the absence of any pathological finding in 91.2 %. For laparoscopic procedures, the numbers are 54.8 and 88.4 %.
CONCLUSIONS
Most German hospitals perform appendectomies laparoscopically regardless of patients' gender. Usage of an Endo-GIA is widely established. SPA has not gained much acceptance, nor is NA widely used yet. In the absence of any pathological findings in particular, the macroscopically inconspicuous appendix results in an appendectomy "en principe" in most German hospitals.
Topics: Appendectomy; Appendicitis; Female; Germany; Health Care Surveys; Humans; Laparoscopy; Male; Practice Patterns, Physicians'; Surveys and Questionnaires
PubMed: 22932909
DOI: 10.1007/s00384-012-1573-9 -
European Journal of Pediatric Surgery :... Jun 2009Laparoscopic appendectomy is now well accepted for the treatment of uncomplicated appendicitis in children. Nevertheless, the effectiveness and safety of laparoscopy in...
INTRODUCTION
Laparoscopic appendectomy is now well accepted for the treatment of uncomplicated appendicitis in children. Nevertheless, the effectiveness and safety of laparoscopy in cases with complicated appendicitis is still controversially discussed. This study evaluates outcomes of laparoscopic appendectomies in children presenting with complicated appendicitis.
MATERIAL AND METHODS
Over a 5-year period (2002-2007), all children presenting to the authors with complicated appendicitis were approached laparoscopically using a standardized protocol and their intra-operative findings and postoperative outcomes were recorded.
RESULTS
Seventy-two consecutive laparoscopic appendectomies for complicated appendicitis were performed with no conversions. The average patient age was 8.5 years. The mean operating time was 45 min. There were no peri-operative complications. The overall rate of postoperative infectious complications was 8.3% (One child developed a large pelvic abscess required ultrasound-guided percutaneous drainage. Two children had multiple intra-abdominal abscesses that resolved with antibiotic treatment. Umbilical port-site infections were encountered in 3 patients). The average length of hospital stay was 5.7 days.
CONCLUSIONS
Laparoscopic appendectomy can be performed safely in children who present with complicated appendicitis. The procedure is efficacious and the complication rate is low.
Topics: Appendectomy; Appendicitis; Child; Female; Humans; Laparoscopy; Length of Stay; Male; Postoperative Complications; Severity of Illness Index; Treatment Outcome
PubMed: 19347804
DOI: 10.1055/s-0029-1202247 -
International Journal of Surgery... 2012Acute appendicitis is perhaps the commonest cause of acute abdomen and surgical intervention in the form of open or laparoscopic appendicectomy. Stump appendicitis is an... (Review)
Review
Acute appendicitis is perhaps the commonest cause of acute abdomen and surgical intervention in the form of open or laparoscopic appendicectomy. Stump appendicitis is an uncommon late complication of appendicectomy; where inflammation occurs in the remaining appendicular stump. Delayed diagnosis of this condition may result in serious complications. This literature review has looked into the clinical presentation, diagnosis and treatment of Stump appendicitis.
Topics: Adolescent; Adult; Aged; Appendectomy; Appendicitis; Child; Female; Humans; Male; Middle Aged; Reoperation
PubMed: 22846617
DOI: 10.1016/j.ijsu.2012.07.007 -
World Journal of Emergency Surgery :... 2018Stump appendicitis is inflammation of remnant appendix tissue due to incomplete removal of the appendix. Due to appendectomy history, stump appendicitis diagnosis is...
BACKGROUND
Stump appendicitis is inflammation of remnant appendix tissue due to incomplete removal of the appendix. Due to appendectomy history, stump appendicitis diagnosis is usually delay and that can cause increase morbidity.
METHODS
Medical records of patients who had surgery for acute appendicitis at a single center from 2008 to 2017 were retrospectively reviewed. During the evaluation of medical records, patients that had a previous operation for acute appendicitis or had "stump appendicitis" as an exploratory finding in operation notes were included.
RESULTS
Appendectomy was performed in 3130 patients (2630 open surgeries and 380 laparoscopic surgeries). Stump appendicitis was diagnosed in five patients (0.15%). The appendectomies had been performed 4, 5, 7, 7, and 11 years previously. Mean time taken for surgery was 36 h after symptoms began. Open surgery was performed in three patients, laparoscopic procedures in others.
CONCLUSION
Awareness of stump appendicitis before radiological examinations may facilitate accurate diagnosis and decrease the duration of the decision-making process, leading to decreased morbidity.
Topics: Adult; Appendectomy; Appendicitis; Appendix; Female; Humans; Laparoscopy; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 29849750
DOI: 10.1186/s13017-018-0182-5 -
Surgical Endoscopy Apr 2011Laparoscopic appendectomy has gained wide acceptance. This study aimed to evaluate the feasibility, safety, and cosmetic results of a novel technique: single incision... (Clinical Trial)
Clinical Trial
BACKGROUND
Laparoscopic appendectomy has gained wide acceptance. This study aimed to evaluate the feasibility, safety, and cosmetic results of a novel technique: single incision laparoscopic (SIL) appendectomy.
METHODS
The study enrolled consecutive patients undergoing appendectomy for acute appendicitis. Appendectomy was performed using three trocars and conventional laparoscopic instruments through a single small umbilical incision (length, ~3 cm). The patients received standard pre- and postoperative care and presented for a follow-up visit after a mean of 27 days.
RESULTS
The study cohort consisted of 26 patients (10 women and 16 men) with an average age of 44 years (range, 13-83 years). Of 26 appendectomies, 22 (85%) were achieved through a single surgical site. The mean SIL appendectomy operative time was 58 min (range, 33-107 min). No operative complications occurred. The average postoperative hospital stay was 1.2 days for nonperforated appendicitis and 2.7 days for perforated appendicitis. At the follow-up visit, no patient showed any evidence of incisional hernia. The operative incisions were minimally visible, and all the individuals reported a highly favorable cosmetic outcome.
CONCLUSIONS
The results of the study demonstrated that laparoscopic appendectomy can be achieved through a single umbilical incision using conventional instruments and that this approach is successful, safe, and aesthetic.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Appendectomy; Appendicitis; Esthetics; Feasibility Studies; Female; Humans; Laparoscopes; Laparoscopy; Length of Stay; Male; Middle Aged; Prospective Studies; Umbilicus; Young Adult
PubMed: 20927545
DOI: 10.1007/s00464-010-1332-3 -
Tidsskrift For Den Norske Laegeforening... May 1991Laparoscopic techniques have extended into the operative field of surgery. Appendectomies can be performed laparoscopically. The diagnosis of appendicitis is established...
Laparoscopic techniques have extended into the operative field of surgery. Appendectomies can be performed laparoscopically. The diagnosis of appendicitis is established and the inflamed organ removed directly. The laparoscopic technique reduces the incidence of unnecessary appendectomies and corresponding morbidity. Compared with conventional appendectomy, laparoscopy leads to less post-operative pain and inability to work. We discuss the first nine patients we treated in this way.
Topics: Adult; Appendectomy; Evaluation Studies as Topic; Female; Humans; Laparoscopy; Male
PubMed: 1829553
DOI: No ID Found -
Journal of Pediatric Surgery Feb 2016Laparoscopic appendectomy is becoming an increasingly common operation among children. It is well known that the abdominal wall should not be exposed to the appendix's...
BACKGROUND
Laparoscopic appendectomy is becoming an increasingly common operation among children. It is well known that the abdominal wall should not be exposed to the appendix's inflamed tissue during its removal. Several ways to protect the retrieval site have been described, with controversial results. Elevated costs, large surgical wounds and high contamination risks are typical reported issues.
OBJECTIVE
We describe a safe, cheap and easy technique to remove the appendix after a laparoscopic appendectomy in pediatric patients.
METHODS
We retrospectively collected and analyzed the files of all children operated on at our institution for laparoscopic appendectomy between September 2004 and April 2015. To remove the appendix, we used the cut end of a glove's finger.
RESULTS
We performed 291 laparoscopic appendectomies using this technique during an 11-year period. Patients' ages ranged from 2 to 16years old. The appendix could be extracted using this technique in all the cases. No intraoperative complications related to the technique were observed. Overall, only one patient (0.34%) presented wound complications.
CONCLUSIONS
Avoiding wide surgical incisions and abdominal wall contaminations is essential during laparoscopic appendectomies in children. Our easy, safe and cheap technique allows these important goals to be achieved.
Topics: Adolescent; Appendectomy; Appendix; Child; Child, Preschool; Female; Gloves, Protective; Humans; Intraoperative Complications; Laparoscopy; Male; Retrospective Studies
PubMed: 26707424
DOI: 10.1016/j.jpedsurg.2015.11.013 -
Annals of the Royal College of Surgeons... Apr 2021The COVID-19 pandemic stimulated a national lockdown in the UK. The public were advised to avoid unnecessary hospital attendances and health professionals were advised... (Observational Study)
Observational Study
INTRODUCTION
The COVID-19 pandemic stimulated a national lockdown in the UK. The public were advised to avoid unnecessary hospital attendances and health professionals were advised to avoid aerosol-generating procedures wherever possible. The authors hypothesised that these measures would result in a reduction in the number of patients presenting to hospital with acute appendicitis and alter treatment choices.
METHODS
A multicentred, prospective observational study was undertaken during April 2020 to identify adults treated for acute appendicitis. Searches of operative and radiological records were performed to identify patients treated during April 2018 and April 2019 for comparison.
RESULTS
A total of 190 patients were treated for acute appendicitis pre-lockdown compared with 64 patients treated during lockdown. Patients treated during the pandemic were more likely to have a higher American Society of Anesthesiology (ASA) score ( = 0.049) and to have delayed their presentation to hospital (2 versus 3 days, = 0.03). During the lockdown, the use of computed tomography (CT) increased from 36.3% to 85.9% ( < 0.001), the use of an antibiotic-only approach increased from 6.2% to 40.6% ( < 0.001) and the rate of laparoscopic appendicectomy reduced from 85.3% to 17.2% ( < 0.001). The negative appendicectomy rate decreased from 21.7% to 7.1% during lockdown (< 0.001).
CONCLUSIONS
The COVID-19 lockdown was associated with a decreased incidence of acute appendicitis and a significant shift in the management approach. The increased use of CT allows the identification of simple appendicitis for conservative treatment and decreases the negative appendicectomy rate.
Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Appendectomy; Appendicitis; COVID-19; Conservative Treatment; Delayed Diagnosis; Female; Health Services Accessibility; Humans; Incidence; Male; Middle Aged; Pandemics; Patient Acceptance of Health Care; Practice Patterns, Physicians'; Prospective Studies; Severity of Illness Index; United Kingdom
PubMed: 33682449
DOI: 10.1308/rcsann.2020.7128