J Minim Invasive Surg 1998; 1(1): 115-120

Published online May 20, 1998

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

복강경을 활용한 저침습성 충수절제술

서해현

서남대학교 의과대학 외과학교실

Minimally Invasive Technique of Appendectomy Using Laparoscopic Instruments

Hae-Hyeon Suh, M.D., Ph.D.

Department of Surgery, Namkwang General Hospital, College of Medicine, Seonam University, Kwangju, Korea.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Recently, minimally invasive surgery has been embraced by many surgeons. In comparison to laparoscopic cholecystectomy, surgeons are not as enthusiastic about laparoscopic appendectomy although which was introduced in early 1980s. The most fundamental reason for skepticism is that tradicional skin incisions of open appendectomy have some room for inprovement. I have some experience in small skim incisions 2-3 cm in length for open appendectomy of diagnosed appendicitis. But such a technique could not detect a pathology of other intraperitoneal organs.

Laparoscopic appendectomy is useful for examining the intraperitoneal pathology with minimal skin incision. But, in laparoscopic appendectomy, the total scar length acquired by three or four trocar is not less than 3 to 4 cm. Which is not shorter than conventional open appendectomy. To take advantage of laparoscopic procedure, a new minimally invasive technique of appendectomy for unobese and uncomplicated appendicitis is presented. Initially diagnostic laparoscopy is performed through a minimal skin incision(micorceliotomy) in the right lower abdomen, 1.5 to 2.0 cm in length, to differentiate other pathology. Then appendectomy is performed using conventional surgical instruments under direct vision through the previous skin incision. There were 18 women and 12 men in this series. The mean age 2as 22.6 years. Pathologic findings of appendix were : two normal, thirteen catarrhal, ten suppurative and five gangrenous type. The mean operation time was 30.7 min. The mean frequency of postoperative analgesic requirement(nalbuphine 0.2 mg/kg) was 0.9 times. The mean hospital stay was 4.1 days (range, 2-7 days) and the duration to return to the full social activities was 7.6 days (range, 5-14 days). There was no mortality or morbidity. This technique of appendectomy is a useful method for minimizing the postoperative pain and operative scar, thus enabling the patient an early return to full social activity.

Keywords Laparoscopy, Appendectomy, Microceliotomy, Diagnostic laparoscopy, Minimally invasive surgery.

Article

J Minim Invasive Surg 1998; 1(1): 115-120

Published online May 20, 1998

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

복강경을 활용한 저침습성 충수절제술

서해현

서남대학교 의과대학 외과학교실

Minimally Invasive Technique of Appendectomy Using Laparoscopic Instruments

Hae-Hyeon Suh, M.D., Ph.D.

Department of Surgery, Namkwang General Hospital, College of Medicine, Seonam University, Kwangju, Korea.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Recently, minimally invasive surgery has been embraced by many surgeons. In comparison to laparoscopic cholecystectomy, surgeons are not as enthusiastic about laparoscopic appendectomy although which was introduced in early 1980s. The most fundamental reason for skepticism is that tradicional skin incisions of open appendectomy have some room for inprovement. I have some experience in small skim incisions 2-3 cm in length for open appendectomy of diagnosed appendicitis. But such a technique could not detect a pathology of other intraperitoneal organs.

Laparoscopic appendectomy is useful for examining the intraperitoneal pathology with minimal skin incision. But, in laparoscopic appendectomy, the total scar length acquired by three or four trocar is not less than 3 to 4 cm. Which is not shorter than conventional open appendectomy. To take advantage of laparoscopic procedure, a new minimally invasive technique of appendectomy for unobese and uncomplicated appendicitis is presented. Initially diagnostic laparoscopy is performed through a minimal skin incision(micorceliotomy) in the right lower abdomen, 1.5 to 2.0 cm in length, to differentiate other pathology. Then appendectomy is performed using conventional surgical instruments under direct vision through the previous skin incision. There were 18 women and 12 men in this series. The mean age 2as 22.6 years. Pathologic findings of appendix were : two normal, thirteen catarrhal, ten suppurative and five gangrenous type. The mean operation time was 30.7 min. The mean frequency of postoperative analgesic requirement(nalbuphine 0.2 mg/kg) was 0.9 times. The mean hospital stay was 4.1 days (range, 2-7 days) and the duration to return to the full social activities was 7.6 days (range, 5-14 days). There was no mortality or morbidity. This technique of appendectomy is a useful method for minimizing the postoperative pain and operative scar, thus enabling the patient an early return to full social activity.

Keywords: Laparoscopy, Appendectomy, Microceliotomy, Diagnostic laparoscopy, Minimally invasive surgery.

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