Laparoscopic Appendectomy - Advantages and Indications

Abstract

Introduction: The first laparoscopic appendectomy was performed by Kurt Semm in 1980. Thirty-six years later, the issue of the choice between laparoscopic and open surgery approach as a standard remains controversial.Materials and Methods: Forty-three laparoscopic appendectomies have been performed at our surgery department by one operative team. We had to convert to open surgery in 3(6.98%) cases. Meckel`s diverticulum was found in 1(2.33%) case. Results: The average hospital stay was 4.14 days. We had no lethal outcomes. In two (4.88%) of the cases the patients developed a paralytic ileus as a complication, but no reoperation was necessary. We observed no wound complications. No complications have been observed in the clinical one-month follow-up of the patients after discharge.Conclusions: The laparoscopic appendectomy should be the first choice of surgery in patients with uncomplicated appendicitis or appendicitis with local peritonitis. The laparoscopic method leads to an earlier postoperative patient activity restoration, shorter hospital stay, better pain control, far fewer wound complications and an earlier return to normal life activity. When there is a dissociation between the preoperative data and the laparoscopic findings, the conversion to open surgery is absolutely acceptable. In cases with generalized peritonitis, the open approach is the first method of choice.