Diagnostic Laparoscopy for Suspected Appendicitis

Laparoscopic exploration followed by possible appendectomy is a safe and straightforward approach to the management of appendicitis. Because of the ability to visualize the entire abdomen at operation, it has improved diagnostic utility over open appendectomy and may therefore be advantageous for patients in whom the diagnosis is unclear. A significant percentage of this group can also avoid operative intervention beyond exploration. If the exploration is positive for appendicitis, proceeding to laparoscopic appendectomy has been shown to reduce postoperative hospital stay and decrease the time until a patient resumes normal diet and activity following surgery. Despite the reduction in wound infection with laparoscopic appendectomy, it has been associated with longer operative times and potentially higher rates of intra-abdominal abscess formation. The remaining complications from laparoscopic appendectomy are related to surgical error or diagnostic delay and can be minimized with careful technique and ear ly intervention.