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At least 631 records · Page 35Linked to original sources
PubMed1993

[Experience with laparoscopic appendectomy].

During April to August 1992, laparoscopies were performed in this department in 35 of 100 cases of appendicitis. The average patient age was 29 years; 18 of the 35 (51%) were women; 3 patients were operated on electively, and the rest as emergencies. Appendectomy was performed in 33 (94%), but not in 2 women with sepsis due to tubo-ovarian abscess; In 1 of these 2 we had to convert to laparotomy. Acute appendicitis was found in 20 (57%). In 7 women (20%) gynecologic disease was diagnosed. In 1 case (3%) a carcinoid tumor of the tip of the appendix was found and in another primary peritonitis. In the remaining 6 (17%) no lesions were found. In 33 (94%) a regular diet was resumed 25 hours postoperatively and 25 (71%) were discharged the day after operation. The only complication was an abdominal wall hematoma in a single case, which resolved spontaneously. It is our impression that laparoscopy is a useful diagnostic tool in acute appendicitis, that it is a safe route for appendectomy, and that recovery is quick with minimal complications.

Acute Disease↗
PubMed1995

[Laparoscopic appendectomy in acute appendicitis].

Laparoscopic technology was applied as diagnostic method in 608 patients, 50 patients have undergone laparoscopic appendectomy. There were no diagnostic errors in laparoscopy application. Laparoscopic technology allowed to perform appendectomy quite safely and without any complications. This method permitted considerably reduce terms of treatment of the acute appendicitis patients and quickly restore their ability to work.

Acute Disease↗
PubMed1977

Elective appendectomy at salpingectomy for ectopic pregnancy: is it desirable?

Controversy persists regarding the desirability--indeed, the permissibility--of elective incidental appendectomy at salpingectomy for ectopic pregnancy. A study of 7500 surgical specimens submitted to a central laboratory by physicians working among the Igbos of Nigeria indicates that elective appendectomy is carried out more frequently with elective salpingectomy than with emergency salpingectomy for ectopic pregnancy. However, an extensive review of the literature reveals that the latter procedure is relatively safe, and one that can be recommended provided certain requirements are met.

Appendectomy↗
PubMed1977

Morbidity of appendectomy in patients with acute salpingitis.

Diagnosis of right lower quadrant pain in a woman is frequently confusing. The course of 53 patients who had operation with a normal appendix and no other intra-abdominal pathology is compared with a group of 50 patients with a normal appendix and acute salpingitis. Appendectomies were performed in all cases and there was a lower mortality and morbidity rate in the group of patients with salpingitis. It is, therefore, concluded that appendectomy is a safe procedure in patients with acute salpingitis.

Acute Disease↗
PubMed1996

[Laparoscopic versus conventional appendectomy: a prospective randomized study].

The discussion about laparoscopic appendectomy has increased since the introduction of this method. Randomized comparisons are still feasible, whereas this cannot be stated for other laparoscopic procedures (e.g., laparoscopic cholecystectomy). This randomized controlled trial included 170 patients. Open appendectomy was employed in 83 patients, and 87 were treated laparoscopically. The treatment groups were comparable regarding age, sex, Broca index, ASA classification, preliminary operations, and preoperative leucocytes. No statistically significant differences could be found with respect to surgical and general complications, operating time, consumption of analgesics and antibiotics, and return to work. The analysis revealed a statistically significant shorter hospital stay, a shorter time until return to normal physical activity, and a shorter duration of complaints for the laparoscopic group. We were unable to demonstrate any statistically significant advantage in using the open procedure.

Adolescent↗
PubMed1996

Laparoscopic versus open appendectomy: a prospective randomized trial of 81 patients.

OBJECTIVE: To compare the efficacy of laparoscopic appendectomy (LA) and open appendectomy (OA) in the treatment of acute appendicitis. DESIGN: A prospective randomized trial. SETTING: A university teaching hospital. PATIENTS: Eighty-one patients with a diagnosis of acute appendicitis were prospectively randomized to undergo either LA or OA. The two groups were matched for age and sex. INTERVENTIONS: LA or OA. MAIN OUTCOME MEASURES: Number of days in hospital and time to full recovery. RESULTS: The mean hospital stay for LA was 3.23 days compared with 3.03 days for OA (p < 0.001). The mean number of narcotic injections required for patients in the LA group was 4.05 compared with 5.58 for patients in the OA group (p < 0.001). The mean time to complete recovery for patients in the LA group was 9.0 days compared with 16.2 days for patients in the OA group (p < 0.001). The mean operative time for LA was 73.8 minutes compared with 45.0 minutes for OA (p < 0.001). Three patients in the LA group had intra-abdominal abscesses (p > 0.25). No significant difference in wound infection rates was demonstrated (p > 0.05). Similarly, pain scores at 7 and 28 days showed no significant difference (p > 0.05). CONCLUSIONS: With LA significantly fewer narcotic injections are required and there is a more rapid return to normal activities. LA takes longer to perform and was associated with three intra-abdominal abscesses. In cases of simple acute appendicitis the hospital stay for LA is significantly shorter.

Adult↗
PubMed1996

[Evaluation of the basis for elective appendectomy in gynecologic laparotomy].

The usefulness of elective appendectomy in gynecological laparotomy has been discussed on the basis of data from 2157 operations. A high rate of pathology has been found in patients without any clinical manifestations including 56.6% inflammatory changes and 0.51% malignant neoplasmas. Elective appendectomy does not influence complications rate, duration of hospitalisation, excludes the need for future operation and may lower the costs of health care.

Adolescent↗
PubMed1997

Infected hydrocele following laparoscopic appendectomy: case report.

In the literature, specific reported complications after laparoscopic appendectomy include bowel injury, hemorrhage, wound infection, and cecal fistula. We report the occurrence of infected hydrocele after laparoscopic appendectomy in a 20-year-old man. This complication, to our knowledge, has not yet been described in the literature.

Adult↗
PubMedDate not supplied

[Comparison of open and laparoscopic appendectomy].

The first laparoscopic appendectomy was performed by Senn in 1982. Since then, the dilemmas about the validity of this operation in relation to open operation have persisted. Many authors presented the technique modifications and results that are very different. The retrospective results, cost, duration of hospital stay and postoperative recovery analyses for fifty patients in each group were done in this study. Laparoscopic operations were done by "two-handed" technique and in different ways of appendix and mesoappendix closing and cutting. Endoscopic linear cutters were used in the second part of the study. When comparing parameters, laparoscopic operation in relation to open operation is equally safe; quicker; with less postoperative pain; with less wound infections rate; with shorter hospital stay; with less staff time involved; with faster recovery and return to work; more expensive; with better cosmetic effect. In conclusion, laparoscopic appendectomy is better, although more expensive, than open operation, so it should be recommended.

Adolescent↗
PubMed1997

[Laparoscopic appendectomy using the out-transumbilical method-- personal experience].

The author present an account of his experience with 80 laparoscopic appendectomies using the method out (LAPPE-out). It is a method combining the advantages of laparoscopy, i.e. mininvasiveness and the possibility to view the abdominal cavity with the certainty of treating the base of the appendix under direct visual control. As to the length of the operation and its pretentiousness it matches classical appendectomy (class. APPE), as regards postoperative comfort and possibilities of laparoscopy it is clearly superior to the latter.

Adolescent↗
PubMedDate not supplied

[Laparoscopic appendectomy: the indications, limits and results].

A total of 10 young women with suspected acute appendicitis were studied. We investigated the value of laparoscopy in the diagnostic evaluation for possible appendicitis in women of reproductive age. At laparoscopy, appendicitis was diagnosed in seven patients (acute-6, subacute-1). Three women had a normal appendix and a pelvic inflammatory disease, a ruptured ovarian cyst and an ovarian cyst with torsion. Laparoscopic appendectomy was performed in 7 cases; a conversion to open operation were because of torsion of ovarian cyst; a laparoscopic cystectomy was necessary. There were no intraoperative and postoperative complications (no wound infections). Reintroduction of normal diet and discharge from hospital occurred earlier after laparoscopic than open surgery. It is concluded that diagnostic laparoscopy permits earlier definitive diagnosis and prompt institution of appropriate therapy for disease of the female reproductive tract that simulates appendicitis; laparoscopic appendectomy is practical and may have advantages over conventional operation (reduction of wound infections and earlier return to normal activities).

Acute Disease↗
PubMed1997

[Prevention and therapy of complications in laparoscopic appendectomy].

It has been verified that laparoscopic appendectomy increases safety. The indications for laparoscopic appendectomy depend on the surgeon's confidence in diagnosis, his skills and the stage of appendicitis. The complications could be prevented by placement of open trocars and (dividing the mesoappendix and appendix with sutures, clips or staples. Electrosurgery should never be used. Bipolar electrosurgery should be limited to 20 Watt power for 5 s. The appendix is removed either though a trocar or in a specimen bag.

Abdominal Abscess↗
PubMedDate not supplied

Kurt Semm and the fight against skepticism: endoscopic hemostasis, laparoscopic appendectomy, and Semm's impact on the "laparoscopic revolution".

In the 1970s, Semm developed thermocoagulation, adapted the Roeder Loop, and further invented extra- and intracoporeal endoscopic knotting to achieve endoscopic hemostasis. His numerous technical inventions, especially the electronic insufflator, allowed more complex operations to be performed laparoscopically. His technique, however, was not quickly adopted by the surgical community. When the first fully laparoscopic appendectomy was carried out by Semm in 1980, a veritable storm broke loose. In the opinion of many prominent surgeons, Semm exaggerated the problem of adhesions, and laparoscopic technique itself was regarded as very dangerous. Misunderstood by medical scientists, Semm displayed an ability to force his ideas through despite skepticism and suspicion. He realized that endoscopic surgery had tremendous potential, and promoted laparoscopic technique not only in his field of gynecology but among general surgeons as well. In 1985, Muhe, of Boblingen, Germany, used Semm's technique to remove the first gallbladder in the world laparoscopically. Three years later when Semm presented a videotape of his laparoscopic appendectomy in Baltimore, he gave impetus to McKernan and Save of Marietta. Georgia, to carry out the first laparoscopic cholecystectomy in the United States.

Appendectomy↗
PubMed1998

[Changes in indications in laparoscopic appendectomy?].

Acute appendicitis requires timely surgery. Still history and physical exam essentially lead us to the diagnosis. The definite histological-pathological finding of acute inflammation postoperatively confirms the diagnosis. Other findings especially chronic or chronic-recurrent inflammation should rise doubt. Therefore other criteria are needed to evaluate the quality of diagnosis for instance the nearly equal male to female relation of 1:1 in all appendectomies as well as in each decade. Today the principles of a strict indication for appendectomy becomes more loose because of the use of laparoscopy as we have shown in or own investigations. The valid standard have to be kept up, on the other hand we must reconsider the indication for surgery under the diagnosis "chronic or chronic-recurrent appendicitis".

Adolescent↗
PubMed1998

[Laparoscopic appendectomy from the gynecologic viewpoint. A report of experiences].

From November 1992 until the middle of 1997 we had 80 laparoscopic appendectomies in our gynaecological department of the district hospital Parchim. These procedures were done with the Semm 3-sling-technique. Recurrent abdominal pain, ovarial tumor, dysmenorrhoea and the wish of sterilisation were the main indications for laparoscopy. Visible pathological changes of the appendix vermiformis led to the laparoscopic appendectomy. Complications were seen only in three cases in the postoperative period. Conclusions and recommendations are given.

Adolescent↗
PubMed1998

[Pro and contra laparoscopic appendectomy in childhood].

The question should be cleared, if and to what extent the indication for appendectomy has changed since the beginning of the minimal invasive surgery in childhood. At first we had the chance to compare two patient groups in the different locations of the clinic for paediatric surgery in the Humboldt-University before their consolidation, because the indication for laparoscopic appendectomy was differently decided. The analysis of these two patient collectives (more than 50 children each) showed, beside the well known different preoperative parameters (age, sex allotment and anamnesis) the distinct indications finding for the minimal invasive procedure. In one group even the acute inflammatory appendicitis was excluded from the laparoscopic technique, in the other group only the sonographic proved perityphlitic abscess was excluded. In this group--corresponding to the more generous indication--there were more wound healing complications after phlegmonous and gangrenous appendicitis--even a little more (0.4%) than in a compared conventional operated collective. Cause of this reason the indication for the laparoscopic technique was defined more rigid (excluding the acute inflammatory disease), to get a high quality standard. The following 350 children after having appendektomy were analysed in the from now on merget locations under special consideration of postoperative complications. Including 54 laparoscopic procedures we saw significant less complications and registered a better average outcome including living quality criteria.

Adolescent↗
PubMed1998

[Laparoscopic versus conventional appendectomy].

From 1/1995 to 8/1997 857 appendectomies were observed in a prospective study. From then on in our clinic has done more laparoscopic then conventional operations, and has developed in the years before a permanent laparoscopic team. For all operations resterilized MIC-instruments are used. Preparation is done with bipolaric instruments and scissor, the appendix stump is supplied a with Röder-sling. The expensive Endo-GIA was used only 3x, if the coecumpole was also inflamed. Because of the fantastic intraabdominal view additional findings quickly be recognized through the laparoscopic method. It was then possible, to plan the therapeutic management exactly. Also variations of the appendix-position are seen clearly and can be operated on without other incisions. There is no significant difference in time between the two methods as we have seen here in practice (35.3 minutes for the conventional and 43.8 for the laparoscopic operation)--they will assimilate, when the surgeon is routine. Fat and muscular patients profit definitely. The problems of wound infection have been rarely observed by the laparoscopic operation. The rate of intraabdominal abscesses was 1.9% and therefore higher as by the conventional method (0.2%). This could be reduced during the period of the study, because we now often lavage and drain. We think that there are no surgical opponent indication to the laparoscopic appendectomy. The reliable conventional technique has to be an obligate technique also in future.

Adolescent↗