Our Summary

Appendicitis is a common cause of severe stomach pain and is often treated with a surgical procedure called laparoscopy. Current medical guidelines suggest that even if the appendix appears normal during surgery, it should still be removed if it was suspected to be the cause of the pain. This study aimed to find out how many patients have had their appendix removed even though it was found to be normal after surgery - this is referred to as a “negative appendectomy”.

The researchers looked at 74 different studies involving a total of 76,688 patients who had undergone surgery for suspected appendicitis. They found that the rate of negative appendectomies varied widely, from 0% to 46% in the different studies. However, based on their overall analysis, they estimated that about 13% of surgeries resulted in a negative appendectomy.

Despite this overall estimation, the results from individual studies varied a lot. This inconsistency means that the certainty of their findings was rated as moderate. Nevertheless, they concluded that around 13% of patients might undergo a negative appendectomy during laparoscopic surgery for suspected appendicitis.

FAQs

  1. What is a “negative appendectomy”?
  2. What percentage of patients undergo a negative appendectomy during laparoscopic surgery for suspected appendicitis, according to the article?
  3. How did the researchers conclude the rate of negative appendectomies?

Doctor’s Tip

Therefore, it’s important to discuss the risks and benefits of surgery with your doctor before proceeding with a laparoscopic appendectomy. Additionally, make sure to follow your doctor’s post-operative instructions carefully to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy are those who present with symptoms of appendicitis, such as severe abdominal pain, nausea, vomiting, and fever. Additionally, patients who have imaging studies that suggest appendicitis, such as ultrasound or CT scan, may also be candidates for laparoscopic appendectomy.

It is important for healthcare providers to carefully evaluate and consider the likelihood of appendicitis before recommending surgery, as the risk of a negative appendectomy can lead to unnecessary complications and costs for the patient. In cases where the diagnosis is unclear, close monitoring and further diagnostic testing may be necessary before proceeding with surgery.

Timeline

Before laparoscopic appendectomy:

  • Patient experiences severe stomach pain, often localized in the lower right abdomen
  • Patient may also have nausea, vomiting, loss of appetite, and fever
  • Patient undergoes physical examination, blood tests, and imaging tests (such as ultrasound or CT scan) to diagnose appendicitis
  • If appendicitis is suspected, patient is scheduled for laparoscopic appendectomy

After laparoscopic appendectomy:

  • Patient undergoes general anesthesia and small incisions are made in the abdomen
  • Surgeon inserts a small camera (laparoscope) and specialized instruments to remove the appendix
  • Recovery time is shorter compared to open surgery, with most patients able to go home the same day or within 1-2 days
  • Patient may experience mild pain, bloating, and shoulder pain from the carbon dioxide used during surgery
  • Patient is advised to rest, avoid heavy lifting, and follow a specific diet for a few weeks
  • Follow-up appointments are scheduled to monitor healing and address any concerns

Overall, laparoscopic appendectomy is a common and effective treatment for appendicitis, with a low rate of complications. The procedure allows for quicker recovery and minimal scarring compared to traditional open surgery.

What to Ask Your Doctor

Some questions a patient may want to ask their doctor about laparoscopic appendectomy include:

  1. What are the potential risks and complications associated with laparoscopic appendectomy?
  2. How long is the recovery time after laparoscopic appendectomy?
  3. Will I need to stay in the hospital after the surgery, and if so, for how long?
  4. How soon can I return to normal activities, such as work or exercise, after the surgery?
  5. Will I have any dietary restrictions after the surgery?
  6. What are the signs of complications that I should watch out for after the surgery?
  7. Will I have a scar after the surgery, and if so, how large will it be?
  8. How likely is it that my appendix will be found to be normal during the surgery (negative appendectomy)?
  9. What is the plan if my appendix is found to be normal during the surgery?
  10. Are there any alternative treatment options for suspected appendicitis that do not involve surgery?

Reference

Authors: Henriksen SR, Christophersen C, Rosenberg J, Fonnes S. Journal: Langenbecks Arch Surg. 2023 May 23;408(1):205. doi: 10.1007/s00423-023-02935-z. PMID: 37219616