Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis

Partecke, Lars Ivo; Bernstorff, Wolfram von; Karrasch, Annette; Cziupka, Katharina; Glitsch, Anne; Stier, A.; Heidecke, Claus Dieter; Tepel, Jürgen

doi:10.1007/s00423-009-0567-8

Cited by 26 publications

(29 citation statements)

References 28 publications

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“…Therefore, the acceptance for laparoscopic appendectomy can be further increased with the degree of standardization. Most surgeons either use a stapler [11] or a loop [6,12] to close the appendicular stump. The use of a stapler is safe and fast but expensive, while the loop is less expensive but requires an advanced level of laparoscopic training.…”

Section: Discussionmentioning

confidence: 99%

“…Fifty-eight laparoscopic appendectomies (70.7%) were performed by surgical trainees (first to fifth year of training, n=7) supervised by one of the abovementioned six board certified surgeons. The surgical procedure followed a standardized protocol as described previously [6]. The procedure only differed from the initial report regarding the closure of the appendicular stump.…”

Section: Methodsmentioning

confidence: 99%

“…Also, the closure of the appendicular stump varies greatly. Recently, we have published data describing a safe and cost-effective method of the closure of the appendicular stump with a PDS loop [6]. However, in our continuous strive of standardizing surgical procedures, we have now started to use single clips for the closure of the appendicular stump similar to the closure of the cystic duct in laparoscopic cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump

Partecke

Keßler

Bernstorff

et al. 2010

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump

Partecke

Keßler

Bernstorff

et al. 2010

Langenbecks Arch Surg

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“…It has been reported that LA has the advantages of fewer wound infections, less pain and faster recovery, especially in obese and elderly patients while resulted in more operating time and hospital costs (2)(3)(4)(5). Other than these advantages, laparoscopic approach offers an additional diagnostic tool at the time of surgery (6) …”

Section: Introductionmentioning

confidence: 99%

Laparoskopi negatif apendektomilerde beklenmeyen bulguları saptamada açık cerrahiye göre üstün müdür?

Yaşar¹,

Uylaş²,

Ateş³

et al. 2017

Bakirkoy

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Laparoskopi negatif apendektomilerde beklenmeyen bulguları saptamada açık cerrahiye göre üstün müdür?Amaç: Laparoskopik apendektomilerin avantaj ve dezavantajları halen araştırılmaktadır. Bu çalışmanın amacı negatif apendektomilerde alternatif tanı açısında açık cerrahi ile laparoskopinin karşılaştırılmasıdır. Gereç ve Yöntem: Ocak 2010 ile Nisan 2014 tarihleri arasında, tek merkezde açık apendektomi uygulanan 397 hasta ile Nisan 2014 ile Aralık 2014 tarihleri arasında aynı merkezde yapılan laparoskopik apendektomiler çalışmaya dahil edildi. Ortalama yaş, cinsiyet dağılımı, preoperatif bulgular (Alvarado skorları ve ultrasonografi bulguları), negatif apendektomi oranları ve negatif apendektomilerde saptanan alternatif tanılar karşılaştırıldı. Bulgular: Hastaların demografik özellikleri, preoperatif bulguları ve negatif apendektomi oranları laparoskopik ve açık cerrahi gruplarında benzerdi (p>0.05) ancak negatif apendektomilerde saptanan alternatif tanı oranları laparoskopik grupta daha yüksekti (%40.0'a kıyasla %19.6, p<0.05). Sonuç: Laparoskopi negatif apendektomi vakalarında alternatif tanının ortaya konulmasında ilave bir tanı aracıdır.Anahtar kelimeler: Açık apendektomi, laparoskopik apendektomi, negatif apendektomi, alternatif tanı ABSTRACT Is laparoscopy superior than open surgery in finding unexpected pathologies in negative appendectomies?Objective: Advantages and disadvantages of laparoscopy in appendectomy is still being investigated. The aim of this study is to investigate open and laparoscopic appendectomies in terms of alternative diagnosis in negative appendectomies. Material and Methods: A total of 397 patients who underwent open appendectomy between January 2010-April 2014 and 120 patients who underwent laparoscopic surgery between April 2014-December 2014 in a single institution were included in the study. Average age and gender distribution, preoperative findings (average Alvarado scores and ultrasonographic findings), rate of negative appendectomies and alternative diagnoses were compared. Results: Patient demographics, preoperative findings and rate of negative appendectomies were all similar in laparoscopic and open groups but the rate of the alternative diagnoses in negative appendectomies in laparoscopic group was significantly greater than in open group. Conclusion: Laparoscopy is an additional diagnotic tool to diagnose alternative pathologic findings in negative appendectomies.

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“…The technical focus in laparoscopic appendectomy is largely on the treatment of appendiceal stump closure. The majority of surgeons use a stapler 7 or a loop 8 to close the appendiceal stump, but although the stapler is safe and fast, it is expensive. On the other hand, the loop is cheaper but it requires a higher level of laparoscopic training.…”

Section: Introductionmentioning

confidence: 99%

Study on the Feasibility and the Safety of Hem-o-lok Clipping for Complicated Acute Appendicitis during Laparoscopic Appendectomy

Kim

Lee

Yang

et al. 2013

J Minim Invasive Surg

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Purpose:The objective of this retrospective study is to evaluate the practical feasibility and safety of applying hem-o-lok clips for the closure of the appendiceal stump in complicated appendicitis.Methods: From January 2009 to April 2010, 267 patients who underwent laparoscopic appendectomies at the Pusan National University Yangsan Hospital were included in this study. Of these patients, 161 were diagnosed by computed tomography as having complicated acute appendicitis. In 107 patients, the appendiceal stump was closed with hem-o-lok clips, whereas in the remaining 160 patients, it was closed with endoloops. These two groups were compared for clinicopathologic data and procedural cost-effectiveness.Results: No significant differences were found between the two groups in terms of age, sex, hospital stay, or blood loss. Furthermore, postoperative complications were similar and highly acceptable in both groups. However, operation times were significantly shorter and hospital cost was lower for the hem-o-lok group.Conclusion: The hem-o-lok clips has advantages such as simplicity of application, a shorter operation time, and lower hospital cost when used as a means of securing the base of the appendix in relation to the endoloop procedure.

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Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis

Abstract: Laparoscopic appendectomy should be recommended as standard procedure for acute appendicitis.

Cited by 26 publications

References 28 publications

Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump

Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump

Laparoskopi negatif apendektomilerde beklenmeyen bulguları saptamada açık cerrahiye göre üstün müdür?

Study on the Feasibility and the Safety of Hem-o-lok Clipping for Complicated Acute Appendicitis during Laparoscopic Appendectomy

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