Laparoscopic Appendicectomy - Now Standard treatment for Acute Appendicitis
Laparoscopic Appendectomy has many apparant advantage over traditional open appendectomy including less pain faster recovery, early return to work and minimum pain. Undoubtedly it is considered as gold standard for female of reproductive age group because of added advantage of improved diagnosis but it is also having many real advantages in male and paediatric age group patient. The possibility for training in the laparoscopic field is great opportunity especially for young surgeons. In this era of Minimal Access Surgery there is stated, that the majority should consider laparoscopic appendectomy as an important step to the advanced procedures. The broad acceptance is recommended.
Despite an apparent consensus on some aspects of appendicitis for acute appendicitis among surgeons, significant inconsistency exists in the operative approach. Some surgeons still perform open appendectomy. The low rate of Laparoscopic Appendectomy suggests that Laparoscopic Surgery for Acute Appendicitis still remains far from being a standard. Personal experience and preference have a major influence on the choice of operative approach but according to our experience the time is now there that laparoscopic appendectomy should be considered as method of choice. It is recommended by World Association of Laparoscopic Surgeons that national guidelines be set up, which could standardize the laparoscopic surgical care for patient with acute appendicitis and also training of laparoscopic surgery for residents.
Laparoscopic surgery is now reality and it is one of the Gold Standard. Despite the increase in use of laparoscopic appendectomy (LA) in recent years, until now no nationwide survey on this issue has been performed. Laparoscopy should be considered now the standard procedure and it should be accepted by the repertoire of general surgeons all over World. Laparoscopic appendectomy should be considered now the method of choice and it should be standard procedure.
Real benefit of laparoscopic appendectomy is always discussed in literature but its standardization is still far from reality. Most cases of acute appendicitis can be treated laparoscopically. The main advantages are:
- Less post-operative pain
- Faster recovery and return to normal activity
- Shorter hospital stay
- Less post-operative complications
- Minimally sized incisions and scars
- Method of choice for patients with HIV and other immunocompromised disease
- Method of choice for patients with cirrhosis and sickle cell disease
- Method of Choice for patients suffering from ectodermal dysplasia
- Favored using laparoscopic appendectomy than open surgery on obese patients with appendicitis
With the accumulated experience in simple appendicitis and its advantage, laparoscopic appendectomy has been more frequently used for even perforated appendicitis and even in patient with pelvic abscess by surgeons experienced in laparoscopy. Although the operation time of laparoscopic appendectomy may be longer, most studies have concluded that laparoscopic appendectomy is superior to open surgery in terms of a faster recovery and less morbidity. For perforated appendicitis with phlegmon, the interval appendectomy does not provide definite advantages over early laparoscopic appendectomy.
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