title: Our experience with selective laparoscopy through an open appendectomy incision in the management of suspected appendicitis.
abstract: BACKGROUND
  An accurate preoperative diagnosis of suspected appendicitis at times can be extremely difficult. We report our experience with a simple strategy of selective laparoscopy through an open appendectomy incision after finding a noninflamed appendix in the management of suspected appendicitis.
  
  
  METHODS
  Patients presenting with suspected appendicitis after regular office hours (6 pm to 8 am weekdays and weekends) were recruited prospectively from January 2002 to December 2003. Laparoscopy through an open appendectomy incision was performed only when the appendix was found to be normal.
  
  
  RESULTS
  Twenty-five (18.5%) of 135 patients underwent laparoscopy through an open appendectomy incision because of a normal-looking appendix. Laparoscopy through an open appendectomy incision helped to identify additional intra-abdominal pathology in 13 (52%) of the 25 patients; thus improving the overall detection rate of underlying pathology from 81.5% (110 of 135) to 91.2% (123 of 135).
  
  
  CONCLUSIONS
  Selective laparoscopy through an open appendectomy incision in patients with a noninflamed appendix is a simple technique that can identify potentially fatal pathology and also maintains a valuable training opportunity for young surgeons to perform open abdominal surgery. We recommend using this technique in the management of suspected appendicitis.
authors.affiliation: Department of Surgery, University Hospital, Dooradoyle, Limerick, Ireland. s21giri@yahoo.co.uk
authors.forename: Subhasis K
authors.initials: SK
authors.lastname: Giri
authors.forename: Faisal M
authors.initials: FM
authors.lastname: Shaikh
authors.forename: Debasri
authors.initials: D
authors.lastname: Sil
authors.forename: John
authors.initials: J
authors.lastname: Drumm
authors.forename: Syed A
authors.initials: SA
authors.lastname: Naqvi
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000473:pathology*; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011028:Pneumoperitoneum, Artificial; D012189:Retrospective Studies