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Laparoscopic Appendectomy

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Emergency Laparoscopy

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Abstract

Items to be concerned when dealing with appendicitis are updated in this chapter. Computed tomography scan keeps its value especially in equivocal cases and obese patients. Diagnostic scores can be useful for the selection of candidates to imaging to lower negative appendectomy rates. Indication to laparoscopic appendectomy remains the gold standard for premenopausal women and is advantageous in the elderly and obese population, while advantages in men are not significant. Complicated appendicitis has better outcomes in laparoscopy, where the importance of drainage, lavage, and conversion has yet to be determined, so as the incidence of postoperative intra-abdominal abscesses or the indication to interval appendectomy. Minor advantages of laparoscopic appendectomy in pregnancy have to be compared with a possible increase of fetal loss. Removal of a normal appendix seems the option of choice in expert hands. Technical notes concerning trocar position, size and number (including mini-laparoscopy, transumbilical laparoscopic assisted appendectomy, and single-port appendectomy) are nowadays feasible options, while surgery through natural orifices is still to be applied under strict surveillance. Costs of laparoscopy are nowadays not a determining factor.

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Authors and Affiliations

  1. Montichiari Surgery Department, ASST Spedali Civili di Brescia, V.le Ciotti 154, 25018, Montichiari, BS, Italy

    Nereo Vettoretto

  2. Surgical Clinic, University of Brescia, P.zza Mercato 15, 25121, Brescia, Italy

    Sarah Molfino

  3. Surgical Clinic, University of Parma, Via Gramsci 14, 43100, Parma, Italy

    Giulia Montori

  4. General Surgery Department, Ospedale Andosilla, Via Ferretti 169, 01033, Civita Castellana, VT, Italy

    Fabio Cesare Campanile

  5. General Surgery Department, Minimally Invasive Surgery Unit, Policlinico San Pietro, Via Forlanini 15, 24036, Ponte San Pietro, BG, Italy

    Mauro Zago

Authors
  1. Nereo Vettoretto
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  2. Sarah Molfino
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  3. Giulia Montori
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  4. Fabio Cesare Campanile
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  5. Mauro Zago
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Correspondence to Nereo Vettoretto .

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Editors and Affiliations

  1. Department of General Surgery, Azienda ULSS19 del Veneto, Adria, Italy

    Ferdinando Agresta

  2. AUSL Viterbo, Ospedale San Giovanni Decollato Andosill, Civita Castellana, Italy

    Fabio Cesare Campanile

  3. Dept of Morfology, Surgery and Experime, School of Medicine, Univ of Ferrara, Ferrara, Italy

    Gabriele Anania

  4. Careggi University Hospital, Florence, Italy

    Carlo Bergamini

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Vettoretto, N., Molfino, S., Montori, G., Campanile, F.C., Zago, M. (2016). Laparoscopic Appendectomy. In: Agresta, F., Campanile, F., Anania, G., Bergamini, C. (eds) Emergency Laparoscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-29620-3_4

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  • DOI: https://doi.org/10.1007/978-3-319-29620-3_4

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