Some say why go for a laparoscopic appendicectomy, when you can have it removed by a micro(!) incision?
LAPAROSCOPIC APPENDICECTOMY has the following advantages over conventional appendicectomy:
1) It allows a proper inspection of the entire abdomen to rule out other pathologies, e/g/ if there is a lesion of the left ovary in a small girl, you can hardly palpate the left ovary with a small micro(!) incision in the right iliac fossa. Whereas with a laparoscope, you can see a magnified close up view of any abdominal organ and treat the pathology.
2) Sometimes, it happens that there is appendicular perforation or an abscess causing pus to accumulate in the abdomen. An open operation does not give you enough access to irrigate the entire abdomen or suck out th epus. With a laparoscope, you can suck out the last drop of pus anywhere in the abdomen and at the same time wash the area with saline.
3) In cases of abnormal positions of the appendix, you need to increase the incision if you opt for an open approach, which significantly adds to the morbidity. In laparoscopic appendicectomy, you can tackle the appendix wherever it is located. You can also treat associated pathology with this approach without any extra incision.
4) In our country, often Tuberculosis causes recurrent abdominal pain. With a laparoscope, you can see the tubercles and just do nothing, or can take a lymph node for biopsy to prove your diagnosis.
5) An open operation for appendicitis even if the skin incision is small, the fascia and the muscles need to be cut for the appendix to be taken out. So despite proper closure, there always remains a chance of development of an incisional hernia. For proper union of the muscles to take place, a period varying from 4 - 8 weeks of rest is mandatory post-operatively failing which there is a chance of development of hernia. But in laparoscopy, since we do not cut the muscles at all, chances of developing a hernia is minimal and the child can actually all normal activities immediately following his/her surgery.
SO LAPAROSCOPIC APPENDICECTOMY IS NOW A GOLD STANDARD FOR ALL VARIANTS OF APPENDICITIS.
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