Levard H, Dubois F
H.I.U.P., Paris.
Chirurgie. 1993;119(8):429-32.
When first described in 1983 by Semm, coelioscopic appendectomy had little impact on the surgical community. However, since 1988, the growing widespread use coeliosurgery has lead to renewed interest in the technique. A survey was conducted among the members of the French Association of Surgery. There were 303 responses from 2,437 questionnaires: 195 concerned coelioscopic appendectomy and included a total of 11,086 cases. Most (55.9%) of the surgeons worked in private hospitals and had already gained experience with coelioscopy for gynaecological indications (56.4%). Programmed coelioscopic appendectomies had been performed by 68.3% and peritonitis was the indication in 48.2%. The meso-appendix was treated with coagulation and/or a clip. Peroperative complications were observed in 132 cases (1.19%). Conversion to laparotomy was necessary in 258 cases (2.33%). No deaths were reported. Postoperative complications were reported in 175 cases (1.58%). There were a total of 106 reoperations (0.95%); 43 times by repeat coelioscopy, 59 times by laparotomy and 4 times by Douglas puncture. Discharge was accorded 3.2 (mean) days after the operation. Coelioscopic appendectomy gives results comparable to the laparotomy technique. Its specific advantages are now being assessed in prospective studies.