Laparoscopic appendectomy (LA) with a new technique.

UNLABELLED: The technique of LA has evolved during the past decade. We describe a simplification using a scope with work channel.

TECHNIQUE: A 1.2 cm paraumbilical trocar enters the CO2(-)-inflated peritoneum. The 1 cm scope with work channel is introduced. If the view confirms the diagnosis of appendicitis we place a 1-cm trocar in the midline 2 cm above the symphysis pubis. The scope is switched to the 1 cm trocar. The appendix is immobilized through the work channel. Through the paraumbilical site the appendiceal artery is clipped or coagulated as necessary. The stump is closed by Roeder loops or stapler. The specimen is removed through the larger site. The wounds are closed with single sutures.

CONCLUSION

This technique has the advantage of being less invasive on the abdominal wall. The sum of the stab wounds is 2.2 cm, requires only one surgeon and the assistance of a scrub nurse. If necessary, the operation it can be converted to 3- or 4-trocar technique or an open one.