Laparoscopic Cholecystectomy Conversion Rates Two Decades Later: An Analysis of Surgeon and Patient-Specific Factors Resulting in Open Conversion

Sakpal, Sujit Vijay; Bindra, Supreet Singh; Paruthi, C.; Chamberlain, Ronald S.

doi:10.1016/j.jss.2009.11.602

Cited by 2 publications

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“…LA has become the standard of practice in uncomplicated appendectomies in most minimally invasive institutions. A US survey in 2005 showed an increased LA rate to approximately 58% of total appendectomies [ 7 ]. While LA encompasses the majority of appendectomies, the high amount of OAs still performed is quite surprising.…”

Section: Discussionmentioning

confidence: 99%

“…OA is widely considered the gold standard in complicated appendicitis (gangrenous and perforated appendices) due to decreased intra-abdominal infectious complications in the postoperative period [ 10 ]. It is also used as an intraoperative backup plan for LA in cases where there is severe appendiceal inflammation (the main reason for conversion to open) or if there are significant adhesions from a previous surgery—all making safe laparoscopic dissection of the appendix nearly impossible [ 7 ]. The rate of conversion from LA to OA is 8.6%, but this number is slowly decreasing as surgeons gain more experience with LA [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is also used as an intraoperative backup plan for LA in cases where there is severe appendiceal inflammation (the main reason for conversion to open) or if there are significant adhesions from a previous surgery—all making safe laparoscopic dissection of the appendix nearly impossible [ 7 ]. The rate of conversion from LA to OA is 8.6%, but this number is slowly decreasing as surgeons gain more experience with LA [ 7 ]. In pediatric patients under the age of 5, where the abdomen is too small for the basic physical requirement of LA, and in pregnancy, due to the risk to the fetus from LA, laparotomy is also still preferred over laparoscopy [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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The Evolution of the Appendectomy: From Open to Laparoscopic to Single Incision

2012

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Beginning with its initial description by Fitz in the 19th century, acute appendicitis has been a significant long-standing medical challenge; today it remains the most common gastrointestinal emergency in adults. Already in 1894, McBurney advocated for the surgical removal of the inflamed appendix and is credited with the initial description of an Open Appendectomy (OA). With the introduction of minimally invasive surgery, this classic approach evolved into a procedure with multiple, smaller incisions; a technique termed Laparoscopic Appendectomy (LA). There is much literature describing the advantages of this newer approach. To name a few, patients have significantly less wound infections, reduced pain, and a reduction in ileus compared with the OA. In the past few years, Single Incision Laparoscopic Appendectomy (SILA) has gained popularity as the next major evolutionary advancement in the removal of the appendix. Described as a pioneer in the era of “scarless surgery,” it involves only one transumbilical incision. Patients are postulated to have reduced post-operative complications such as infection, hernias, and hematomas, as well as a quicker recovery time and less post-operative pain scores, in comparison to its predecessors. In this review, we explore the advancement of the appendectomy from open to laparoscopic to single incision.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Evolution of the Appendectomy: From Open to Laparoscopic to Single Incision

2012

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“…Many new incisions were devised during the following period, that include Rutherford Morison's, Rocky Dave's, Battle's incision and lately Lanz incision for appendectomy [7] . With the advent of laparoscopic appendectomy by Kart Semm, the focus shifted to minimal access surgeries [8] . Even with the widespread application and considerable advantages of laparoscopy, there is debate over the best method of appendectomy in the literature [9] .…”

Section: Introductionmentioning

confidence: 99%

Mini Incision Open Appendectomy

M.S.¹

2019

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Objectives: Appendicitis, being the frequent surgical emergency condition, warrants surgery immediately or electively in order to alleviate complications. Appendectomy can be done through laparoscopic or open access. The incision for open appendectomy varies according to clinical condition of the patient and the surgeon's preference. This study aims at bringing out the advantage, utility and cosmesis of using a mini incision for open appendectomy at our hospital. Materials and Methods: This is a prospective study on patients getting admitted with clinical and radiological evidence of appendicitis. A total of 50 cases were studied during the period from 2016 to 2019. All the patients underwent open appendectomy through a mini incision measuring 2 to 2.5cm preferably under regional anaesthesia. The patients' complete history, clinical profile, operative details, post-operative status, length of hospital stay, condition during follow up were recorded. Results: Out of 50 patients who underwent mini-incision appendectomy, 31 (62%) were male and 19 (38%) were female. 6 cases (12%) required an extension of the incision up to 3.5cm due to difficulty in delivering. Surgical site infection occurred in 3 patients (6%), which were treated conservatively. The average operative period was 28 minutes (20-45 minutes). All the patients had negligible post-operative pain. The condition during follow up was uneventful and the patients had very minimal scar. Conclusions: The mini-incision appendectomy is thus a safe technique for performing open appendectomy with cosmetic advantage.

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Laparoscopic Cholecystectomy Conversion Rates Two Decades Later: An Analysis of Surgeon and Patient-Specific Factors Resulting in Open Conversion

Cited by 2 publications

References 0 publications

The Evolution of the Appendectomy: From Open to Laparoscopic to Single Incision

The Evolution of the Appendectomy: From Open to Laparoscopic to Single Incision

Mini Incision Open Appendectomy

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