Needlescopic appendectomy.
BACKGROUND
In this paper, we compare our experience with the techniques of needlescopic appendectomy (NA) (2-mm instruments) for the treatment of acute appendicitis with the more conventional approach of a laparoscopic appendectomy (LA).


METHODS
We did a retrospective review of patients who underwent NA for the diagnosis of acute appendicitis between August 1996 and January 2002. Variables including operative time, blood loss, postoperative time to discharge, intra- and postoperative complications were analyzed and compared to data from control patients who had undergone an LA for acute appendicitis.


RESULTS
The NA group had a longer average operating time (54.5 +/- l3 vs. 42.5 +/- 12.6 min, p = 0.0001) and a longer postoperative hospital stay (2.1 +/- 1.4 vs. 1.3 +/- 1.1 days, p = 0.01). Blood loss was similar for the two groups.


CONCLUSIONS
With the exception of superior cosmesis, NA appears to have little advantage over the better-established LA; moreover, it has some disadvantages. A clearer benefit of this procedure over LA, as well as improvements in instrumentation, needs to be shown before it can be widely accepted.
Chock
A
A
Department of Surgery, Texas Endosurgery Institute, 4242 E. Southcross Blvd., Suite # 1, San Antonio, TX 78222, USA. achock2121@yahoo.com
Seslar
S
S
Stoopen
E
E
Tristan
A
A
Hashish
H
H
Gonzalez
J J
JJ
Franklin
M E
ME
D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D001064:Appendicitis / Q000601:surgery; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008297:Male; D018583:Pliability; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome