Laparoscopic appendectomy may be safer

When an appendix needs to be removed, patients who have minimally invasive surgery fare far better than those who have traditional operations, a review of several studies indicates.

Patients who had laparoscopic appendectomies had fewer complications, left the hospital faster and went back to work sooner, two Duke University researchers found after reviewing results of studies involving 43,000 patients.
 

• In laparoscopy, surgeons make short incisions, about a quarter-centimetre in length, then insert a tiny camera to guide them as they use cutters, staplers and a tiny sterile bag to remove the appendix.
   
• During the traditional procedure, a surgeon cuts a 5- to 6-centimeter slit in the lower right section of the abdomen; despite stringent sterilisation, the wound can become infected while the organ is removed.
  
  A higher rate of infection from open surgery might be why the Duke study shows patients who undergo traditional appendectomies stay in the hospital about three days, versus two days for laparoscopies.
  
  Although nearly every hospital in the country offers both procedures, some doctors still resist laparoscopies, which have been common since the early 1990s.
  
  One reason might be cost. Doctors say that less follow-up care and fewer postoperative sick days could balance out the expense.
  
  Source: Holly Hickman, Study cites advantages of laparoscopies, Washington Times, December 22, 2003: based on Ulrich Guller et
  al., Laparoscopic Versus Open Appendectomy: Outcomes Comparison Based on a Large Administrative Database, Annals of Surgery, December 22, 2003.
  
  For text
  http://www.washingtontimes.com/national/20031221-114525-8934r.htm
  For more on the Duke study http://dukemednews.org/news/top_story.php
  For study abstract http://www.annalsofsurgery.com/
  For more on New Trends & Technology http://www.ncpa.org/iss/hea/
  
  FMF Policy Bulletin/30 December 2003