LAPAROSCOPIC APPENDECTOMY, ADVANTAGES AND DISADVANTAGES OF LAPAROSCOPY

Abstract

Acute appendicitis develops in a progressive and irreversible manner, even if the clinical presentation of acute appendicitis can be temporarily modified with medication. A reliable and real-time diagnosis of acute appendicitis can be made on the basis of white blood cell counts and improved computed tomography results. Emergency laparoscopic appendectomy is considered the first therapeutic choice for acute appendicitis. Delayed appendectomy between 6-12 weeks after disease onset is risky with a high recurrence rate during the waiting period. However, this technique may have some advantages in avoiding unnecessary extended resection in patients with appendiceal masses. Non-operative treatment of acute appendicitis can be allowed only in children. Postoperative complications increase depending on patient factors, and temporary avoidance of emergency general anesthesia may be beneficial for high-risk patients. The skill of the surgeon and the cooperation of the hospital are important for the success of laparoscopic appendectomy. It is safe to delay appendectomy for less than 24 hours after diagnosis. In addition, a semi-elective approach (ie, laparoscopic appendectomy within 24 hours of symptom onset) may be paradoxically accepted depending on patient, physician, and institutional factors. Immediate laparoscopic appendectomy is mandatory for acute appendicitis.