Acute appendicitis: Standard treatment and the role of laparoscopic surgery

M. W. Büchler, Bern. Acute Appendicitis: The Role of Laparoscopic Surgery. The conclusion at the end of the meeting by M. W. Büchler, Bern, was that the standard treatment for acute appendicitis remains the classic open technique described by McBurney in 1894. Only between 1% (United Kingdom) and 20% (USA) of all cases are removed laparoscopically. However, 12% of all surgical cases are performed for appendicitis and 40% of all small bowel obstructions are related to open appendectomy. The metaanalysis comparing laparoscopic versus open appendectomy showed that laparoscopic appendectomy is more expensive and takes longer, the complication rates are equal and there are no differences concerning pain, recovery and cosmesis. Despite the fact that laparoscopic appendectomy is a safe procedure, open appendectomy remains the standard procedure for clear diagnosis. However, the role of laparoscopic appendectomy in young females, obese patients and unclear diagnosis must be further evaluated. © 1997 Blackwell Science Ltd.