Laparoscopic Appendicectomy:

Mohamed Mahmoud Mohamed

61SUMMARYAcute appendicitis is one of the few surgical diseases encounteredIn which a correct preoperative diagnosis is not conclusive. Negativelaparotomy rate average is 15% to 20% are considered acceptable.Recent advances in laparoscopic technology have led to a dramaticre-evaluation of the surgical management of visceral pathology.Laparoscopic appendectomy is afeasible option in the management ofo acute appendicitis in most cases, it shortens hospital stay and diminish therisk of post operative infection..-The first laparoscopic appendicectomy actually predates the firstlaparoscopic cholecystectomy. The first case oflaparoscopic removal ofan appendix was reported by ”Kurt Semm” in 1983.The indications for laparoscopic appendectomy are not differentfrom those for open appendectomy. The contraindications to the proceduredepend largely on the surgeon’s experience in laparoscopic surgery.Situations .such as generalized peritonitis, untreatable bleeding disorders orcomplete bowel obstruction should be managed with laparotomy.Conditions such as previous right lower quadrant surgery, pregnancy orevidence of an abscess are considered relative contraindications and mightbe attempted depending on the skill of the surgeon.Laparoscopic removal of an acutely inflammed appendix hasconsiderable appeal in that the diagnosis of acute appendicitis can bevarified, other pathologies in right iliac fossa can be identified and iffeasible the appendix removed through alaparoscopic cannula thus62avoiding direct contact of contaminated contents with the abdominalwound.Laparoscopic surgery has the advantage of minimal pam anddisability, low cost when performed at economic scales, can be performedas outpatient procedures, short hospital” stay, and has gained wellunderstoodpatient acceptance .. Similar to all other surgical manoeuvers, laparoscopy has its owncomplications. Some are recognized during the operation, while othersdevelop in the postoperative period. During the operation. bleeding mayoccur from the abdominal wall vessels or intra-abdominally from an.. injured vessel or liver substance. An intra-abdominal organ may bedamaged; the common bile duct. the urinary bladder and the intestinalloops being commonly vulnerable .