Updates in Surgery

, Volume 64, Issue 4, pp 285–288 | Cite as

Lesson learned from 10 years’ experience in laparoscopic appendectomy in a community hospital

  • Nereo Vettoretto
  • Giulia Montori
  • Michele Bartoli
  • Maurizio Giovanetti
Original Article

Abstract

The debate between open and laparoscopic appendectomy is now overtook by the need of a standardized technique, as laparoscopy, in the elective and emergency setting, is widely disseminated thorough surgical practices. A retrospective review of a 10 years’ case history (838 laparoscopic appendectomies) is analyzed, and the last 5 years experience (300 cases) compared to the previous experience after the adoption of a standardized technique, which comprehends an all-comers policy without patients’ selection prior to explorative laparoscopy. No post-operative infections have been recorded, neither intra-abdominal abscesses nor wound infections, in the laparoscopic group. Significant differences (p < 0.05) have been found between the rate of peritonitis and male sex, elderly patients, and the use of stapler for the treatment of the appendiceal stump. Also conversion to laparotomy has been associated with complicated appendicitis, while associated diseases are found more frequently in fertile women. No differences in the operating time have been evidenced between laparoscopic, open or converted appendectomy. We sustain that every patient with a suspect of appendicitis should have a laparoscopic chance, indeed maintaining a low threshold for conversion; and that surgical indication should be anticipated for male and elderly patients, in order to lower the rate of complicated appendicitis.

Keywords

Laparoscopy Appendectomy Case series Complications Technique 

Notes

Conflict of interest

None to declare.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Nereo Vettoretto
    • 1
  • Giulia Montori
    • 2
  • Michele Bartoli
    • 2
  • Maurizio Giovanetti
    • 3
  1. 1.Laparoscopic Surgical UnitM. Mellini HospitalChiariItaly
  2. 2.Surgical ClinicUniversity of BresciaBresciaItaly
  3. 3.General and Vascular SurgeryM. Mellini HospitalChiariItaly

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