Initial experience with laparoscopic appendectomy.

As experience with laparoscopy increases, new applications in general surgery are being identified. Treatment of acute appendicitis through the laparoscope has been proposed. We present our initial experience with this new technique. Over a 12-month period, laparoscopic appendectomy was attempted in 29 patients. There were no intraoperative complications. Two cases required conversion to the open technique owing to gangrene at the appendiceal base. The average operating time was 64 minutes. Two of nine patients with perforated appendicitis developed a pelvic abscess, and one patient developed wound cellulitis. Pain medication requirements were minimal, bowel function returned rapidly, and half of the patients were discharged on postoperative day one or two and returned to normal activity within one week. Based on our initial experience, it appears that laparoscopic appendectomy is a safe and effective technique for managing acute appendicitis and offers advantages in terms of decreased pain, decreased hospital stay, and a rapid return to normal activities.