“Is the laparoscopic method better for appendicitis?”
My doctor gave me two options for my appendix removal: laparoscopic method or open surgery. I know that laparoscopic is way less invasive than the other alternative. But how successful is it? Do you think that this way is better than the other?
11 Answers
Laparoscopic surgery for the appendix is now almost considered the gold standard. Open surgery should be considered only for the most complex ruptured cases of appendicitis.
The better method is the one that the surgeon is best at. That said, it is my impression that most are done laparoscopically. It is my preferred approach.
Dr. Oday Obaid
Surgeon
Laparoscopic appendectomy became a routine and standard approach to removing an appendix. Open approach is reserved for cases in which proceeding with the laparoscopic approach would not be safe.
Hi,
I'm a surgeon from Belgium. In my point of view laparoscopic appendicectomy is the gold standard. In my hospital, it's very rare to do it by laparotomy.
I'm a surgeon from Belgium. In my point of view laparoscopic appendicectomy is the gold standard. In my hospital, it's very rare to do it by laparotomy.
Laparoscopic technique is far superior to open technique in almost every way. The procedure is much shorter, leading to less time under anesthesia. Recovery is infinitely better. Most people return to work within 1 week after laparoscopic, but many are out of work longer than a month with open. Complications are much lower with laparoscopic (fewer wound infections, less ileus, lower dvt rate, lower risk of hernia, less pain). This answer is fact, not opinion. Anyone who offers someone an open approach without first attempting laparoscopic should lose their license. Relative exceptions to this are concerns for malignancy, a history of many pelvic AND abdominal surgeries, and known abscess on imaging.
It all depends on the surgeon and their training, but most surgeons now days prefer the laparoscopic approach for most appendicitis cases and believe is a better approach to minimize complications. Occasionally, there are cases where open surgery is needed for a variety of reasons and conversion from laparoscopy to open procedure is also a possibility if the surgeon encounters problems or reasons the surgery can not be completed with laparoscopic approach (rare occasion). Best person to ask these question is your surgeon since there are so many variables to consider to making the decision for the surgical approach.
Recovery is faster. Most are discharged the next day. Have done over 1000 and the outcomes are far better than open procedure.
Laparoscopic surgery is by far the way to go. Significantly less complication rate. There is a long-term benefit of decreased hernia rate, decreased adhesion rate, and decreased obstruction rate with laparoscopic surgery. In the short term, it is a much faster recovery and significantly less pain. I have never offered an open appendectomy to a single one of my patients.