The Superiority of Laparoscopic Appendectomy: Myth or Reality?

Background: Laparoscopic appendectomy is a laparoscopic intervention that could be achieved with the improvement of laparoscopic instruments and technology. It presented an upward trend in recent years despite the many controversies surrounding this type of intervention. In our clinic was a “bridge route” to acquire advanced laparoscopic surgical techniques.
Methods: Comparative analysis of laparoscopic appendectomy and classic appendectomy; establishing the superiority of laparoscopic approach. We have studied the casuistry of the Surgery Clinic I of the County Emergency Clinical Hospital Tîrgu Mureș for the 2008–2011 period (3 and half years). Several parameters were analyzed.
Results: In the analyzed period 209 appendectomies were performed: 98 (53%) by laparoscopic approach and 111 (47%) by open approach. 49.13% of all women operated received laparoscopic surgery, while only 44.08% of men have had this approach. The time of laparoscopic surgery was on average 13.10 minutes longer than the classic. Conversions were 10% of total laparoscopic interventions. Complications that required reintervention were recorded in 1 case (20%) after the laparoscopic approach, as opposed to 4 cases (80%) for the classic approach.
Conclusions: Laparoscopic appendectomy weight increased progressively from year to year. The average duration of laparoscopic appendectomy learning curve was part of any specific type of laparoscopic intervention. The benefits of this type of intervention are clear, as represented by the possibility of exploring the peritoneal cavity and differential diagnosis of “painful right iliac fossa syndrome” in women, can guide classic approach in case of conversion, rapid mobilization and early resumption of transit, decreased parietal pain, a lower rate of parietal infection, short-term hospitalization and faster reintegration in activity.