Our Summary

This research paper looks at the effectiveness of two different methods of appendectomy - laparoscopic (performed through small incisions using a camera) and open (traditional surgery with larger incision). It studied almost 1900 patients who underwent these procedures at a hospital in Croatia from 2009 to 2016. The study also considered situations where the appendix was found to be normal, with or without other diseases present.

The results showed that there was no significant difference in the rate of ’negative appendectomies’ (where the appendix was normal) between the laparoscopic and open methods, for both adults and children. This means that the choice of surgery method did not impact the number of unnecessary surgeries.

However, the study did find that the rate of appendix perforation (bursting or tearing) was significantly higher in the traditional open surgery approach, for both adults and children.

Based on these findings, the study concluded that laparoscopic appendectomy should be the preferred method for patients suspected of having appendicitis, given its comparable effectiveness and lower risk of complications.

FAQs

  1. What were the two methods of appendectomy compared in this study?
  2. Did the choice of surgery method impact the number of ’negative appendectomies'?
  3. Based on the study’s findings, which method of appendectomy is recommended for patients suspected of having appendicitis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is that it is a minimally invasive procedure that typically results in less pain, shorter recovery time, and lower risk of complications compared to traditional open surgery. It is important to follow post-operative care instructions, such as avoiding heavy lifting and staying hydrated, to ensure a successful recovery.

Suitable For

Typically, patients who are recommended for laparoscopic appendectomy are those suspected of having appendicitis. This includes patients experiencing symptoms such as abdominal pain, nausea, vomiting, and fever. In cases where the appendix is found to be normal, laparoscopic appendectomy is still recommended as it has been shown to have a lower risk of complications, such as appendix perforation, compared to traditional open surgery. Overall, laparoscopic appendectomy is considered a safe and effective option for patients with suspected appendicitis.

Timeline

Before Laparoscopic Appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes physical examination, blood tests, and imaging studies to diagnose appendicitis.
  3. Decision is made to proceed with laparoscopic appendectomy.

During Laparoscopic Appendectomy:

  1. Patient is placed under general anesthesia.
  2. Surgeon makes small incisions in the abdomen and inserts a camera and surgical instruments.
  3. Surgeon removes the appendix using the laparoscopic technique.
  4. Procedure typically lasts around 30-60 minutes.

After Laparoscopic Appendectomy:

  1. Patient wakes up in the recovery room and is monitored for any complications.
  2. Patient may experience some pain and discomfort at the incision sites.
  3. Patient is typically discharged from the hospital within 24 hours.
  4. Patient is advised to rest and avoid strenuous activities for a few days.
  5. Patient follows up with the surgeon for post-operative care and monitoring.
  6. Patient can return to normal activities within 1-2 weeks.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic appendectomy include:

  1. What are the benefits of laparoscopic appendectomy compared to traditional open surgery?
  2. What are the risks and potential complications associated with laparoscopic appendectomy?
  3. How long is the recovery time expected to be after a laparoscopic appendectomy?
  4. Will there be any scarring or long-term effects from the procedure?
  5. Are there any specific criteria or factors that may make me a better candidate for laparoscopic appendectomy?
  6. How experienced are you in performing laparoscopic appendectomies?
  7. Are there any alternative treatment options available for appendicitis?
  8. What is the success rate of laparoscopic appendectomy in treating appendicitis?
  9. How will pain management be handled after the surgery?
  10. What should I expect during the recovery process and what follow-up care will be needed?

Reference

Authors: Augustin G, Čižmešija Z, Žedelj J, Petrović I, Ivković V, Antabak A, Mijatović D, Škegro M. Journal: Acta Clin Croat. 2018 Sep;57(3):503-509. doi: 10.20471/acc.2018.57.03.14. PMID: 31168184