Laparoscopic Appendectomy

The advent of high definition video-laparoscopy has transformed the laparoscopic appendectomy into an elegant, reliable procedure which can be easily performed. In most cases it can be completed within 20 to 30 minutes, and with experience, all clinical settings can be mastered. Critics of this procedure have claimed there are no significant cost savings and no improvement in the recovery of the patient. The following results will disprove these claims. This procedure remains invaluable in patients with undiagnosed abdominal pain requiring further diagnostic intra-abdominal exploration as well as patients with perforated appendicitis with or without an intra-abdominal abscess.

In addition, this technique truly makes the simple appendectomy an outpatient procedure. The patient can resume a diet within a few hours after the "lap-appy" and in most cases can be discharged within 24 to 36 hours. 

The indications for a laparoscopic appendectomy are simple. Any patient suspected to have an acute appendicitis should undergo a laparoscopic appendectomy. As our laparoscopic skills have dramatically improved over the past decade, we now rarely schedule a patient to undergo an "open" appendectomy.

In addition, all surgeons are now well aware that the introduction of spiral computerized tomography has significantly impacted the diagnostic management of these patients. In selected clinical settings, careful use of this imaging modality will improve the diagnostic acumen of the clinician beyond the 95 percentile.