[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.
Ritter
C
C
Chirurgische Klinik, DRK-Kliniken Berlin-Köpenick.
Sahm
M
M
Kubo
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000295:instrumentation / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D020706:Laparoscopes; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D013525:Surgical Instruments; D013528:Surgical Staplers