Diagnostic laparoscopy through the right lower abdominal incision following open appendectomy

Abstract

Diagnostic laparoscopy through the right lower quadrant incision may help to correct the diagnosis in patients who are operated on for clinically acute appendicitis but in whom no acute appendicitis or other pathological findings are seen.

Conversion From Open to Laparoscopic Treatment of Peritonitis: “Reversed Conversion” Revisited

“…Reversed conversion, a term coined by Navez et al 18 in 2001 means converting from the open to laparoscopic approach. The technique, however, was in fact first described by Schrenk et al 29 as a complement to laparoscopic exploration of the abdomen when no obvious pathology of the appendix was found, and who treated 2 cases of peritonitis of genital origin after reversed conversion. Navez et al 18 described this approach in 4 of 96 cases of appendicitis initially operated on through a 2-to 3-cm McBurney incision.…”

Ergonomics and Technical Aspects of Minimal Access Surgery in Acute Surgery

“…After a small (10-12-mm) incision in the RLQ, largely adequate to extract a locally inflamed appendix, if the pathology encountered cannot be managed through that small incision, or if there is peritonitis, then a 10-mm 30°scope is inserted via this incision and the fascia is partially sutured. Depending on the findings, further ports are inserted [56] in order to treat the cause of the peritonitis, as well as toileting the peritoneal cavity.…”

Diagnostic Laparoscopy for Suspected Appendicitis

“…Other groups have suggested exploratory laparoscopy through the right lower quadrant appendectomy incision either before 27 or after appendectomy. 28 As surgical experience with laparoscopy has increased, laparoscopic appendectomy more frequently follows positive laparoscopic exploration. 29 During diagnostic laparoscopy, extra-appendiceal pathology is occasionally identified.…”