Laparoscopic Appendectomy

Laparoscopic appendectomy is a minimally invasive endoscopic surgical procedure to remove the appendix. From December 1990 to February 1991, Tripler Army Medical Center performed laparoscopic appendectomies on 25 patients diagnosed with acute appendicitis. Our technique uses Hulka clips across the mesoappendix, endoloop ligatures around the appendiceal base and a latex rubber bag to extract the appendix. Twenty-three of our patients had a pathologically confirmed diagnosis of acute appendicitis, with 60% of the cases categorized as suppurative, necrotic, gangrenous or perforated.One patient was switched from laparoscopic management to open laparotomy when a necrotic appendiceal base disintegrated following application of endoloops and two patients had minor complications. Patients stayed in the hospital an average of 1.5 days, returned to work and regular activities within a week, and were generally pain-free within four to five days of the operation. Our early results have been extremely encouraging. Laparoscopic appendectomy appears to be a safe, cost-effective, minimally invasive surgical technique that in skilled hands may be used to remove most diseased appendices.