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Laparoscopic appendicectomy

Hariscine Keng Abongwa, G Cervellin, A Tarasconi, G Perrone, G Baiocchi, N Portolani, F Catena
BACKGROUND: Clinical trials have so far shown controversial results as regards the standard of care for treating uncomplicated acute appendicitis (uC-AA). High operational risk adult patients (HORAP) could represent selected patients where primary antibiotic conservative therapy (pACT or A) could be indicated. METHODS: We carried a comprehensive search of the PubMed searching engine in the English language scientific literature from 1995 to 2015, using medical subject headings "antibiotics", "uncomplicated appendicitis", "appendicectomy", "conservative treatment", "surgery" and "randomized clinical trial"...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
V Grassi, J Desiderio, A Cacurri, A Gemini, C Renzi, Alessandro Corsi, I Barillaro, A Parisi
Foreign body ingestion is not an uncommon problem in clinical practice. While most ingested foreign bodies pass uneventfully through the gastrointestinal tract, sharp foreign bodies such as toothpicks should cause intestinal perforation. We reported the case of a perforation of the appendix caused by a toothpick, which also pierced the liver without hepatic damages, in a male with an intestinal malrotation and subhepatic appendix. The patient was admitted to our hospital for abdominal pain in the right upper quadrant...
July 2016: Il Giornale di Chirurgia
Andrew Phillip Maurice, Hany Ibrahim, Robert Franz, Harish Iswariah
A 31-year-old healthy man presented with right lower quadrant pain and tenderness, mild neutrophilia and clinical presentation consistent with appendicitis, despite undergoing a laparoscopic appendicectomy 5 years prior. CT scan demonstrated a caecal phlegmon, in the expected region of the appendiceal stump. The patient was taken for laparoscopy and a 2 cm inflamed appendiceal stump was encountered. A distal caecectomy was performed and the patient made an unremarkable recovery. Histological examination was consistent with acute inflammation of the appendiceal stump...
October 27, 2016: BMJ Case Reports
Rikki Singal, Muzzafar Zaman, Amit Mittal, Samita Singal, Karamjot Sandhu, Anshu Mittal
BACKGROUND: Laparoscopy is widely practiced and offers realistic benefits over conventional surgery. Port closure is important after a laparoscopic procedure to prevent port site incisional hernia. Larger port size and increasing numbers of ports needed to perform more complex laparoscopic procedures are likely to increase the incidence of port site hernias (PSHs). PSHs tend to develop more frequently at umbilical and midline port sites due to the thinness of the umbilical skin and weaknesses in the linea alba...
October 2016: Gastroenterology Research
Omar E Aly, Douglas H Black, Haroon Rehman, Irfan Ahmed
BACKGROUND: Appendicectomy is a well-established surgical procedure used in the management of acute appendicitis. The operation can be performed with minimally invasive surgery or as an open procedure. A further development in the minimally invasive appendicectomy technique has been the introduction of single incision laparoscopic surgery (SILA). AIM: To ascertain any differences in outcomes from available trials comparing SILA with conventional multi-incision laparoscopic appendicectomy (CLA)...
November 2016: International Journal of Surgery
Nicole N Winter, Glenn D Guest, Michael Bozin, Benjamin N Thomson, G Bruce Mann, Stephanie B M Tan, David A Clark, Jurstine Daruwalla, Vijayaragavan Muralidharan, Neeha Najan, Meron E Pitcher, Karina Vilhelm, Michael R Cox, Steven E Lane, David A Watters
BACKGROUND: Recent data suggest that laparoscopic appendicectomy (LA) in pregnancy is associated with higher rates of foetal loss when compared to open appendicectomy (OA). However, the influence of gestational age and maternal age, both recognized risk factors for foetal loss, was not assessed. METHOD: This was a multicentre retrospective review of all pregnant patients who underwent appendicectomy for suspected appendicitis from 2000 to 2012 across seven hospitals in Australia...
September 6, 2016: ANZ Journal of Surgery
Emma Patricia Stewart-Parker, Mustafa Atta, Sudeendra Doddi
A previously healthy 10-year-old boy presented to the emergency department with central abdominal pain, loose stool and vomiting. He was diagnosed with gastroenteritis, but was well enough to be discharged. The next day he reattended with ongoing diarrhoea and vomiting, with the pain now localised to the right iliac fossa (RIF). Acute appendicitis was suspected, and he was taken for laparoscopic appendicectomy. At surgery, a gangrenous appendix was found, with pus extending from the pelvis up to the liver. The appendix was excised and thorough peritoneal washout performed...
August 3, 2016: BMJ Case Reports
R Kumar, R F Bamford, D Kumar, G Singh-Ranger
Appendagitis is an uncommon clinical entity, often not recognised, and mistaken for more serious infective conditions. We describe a proven case of appendagitis which occurred after confirmed appendicitis. We postulate that this condition can coexist with appendicitis and indeed may be the result of coinflammation. This has several implications. Firstly, clinicians must retain an index of suspicion for this condition in a patient with localised abdominal pain which occurs after appendicitis. Secondly, it would be reasonable to suggest careful examination of colocated appendages in a patient with an otherwise normal-appearing appendix...
2016: Case Reports in Surgery
Rowan Ousley, Laura L Burgoyne, Nicola R Crowley, Warwick J Teague, David Costi
BACKGROUND: Patient-controlled analgesia (PCA) is commonly used after appendicectomy in children. AIM: The aim of this study was to characterize the analgesic use of children prescribed PCA after appendicetomy, in order to rationalize future use of this modality. METHODS: We retrospectively audited all cases of acute appendicitis over a 4-year period in a single pediatric hospital, recording demographics, surgical approach, pathology, analgesia use, pain scores, and duration of PCA...
October 2016: Paediatric Anaesthesia
Raymond Yap, Mark Cullinan
BACKGROUND: Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy...
June 9, 2016: ANZ Journal of Surgery
James K Hamill, Andrew G Hill
During the latter half of the 19th century, surgeons increasingly reported performing appendicectomies. Fitz from Harvard, Groves from Canada and Tait from Britain all recorded successful removal of the appendix. McBurney described the point of maximal tenderness in classic appendicitis and also the muscle-splitting incision centred on this point. Priority is given to McArthur in describing the lateral muscle-splitting incision. The direction of the cutaneous incision was later modified by Elliott and Lanz...
October 2016: ANZ Journal of Surgery
Vikesh Agrawal, Himanshu Acharya, Roshan Chanchlani, Dhananjaya Sharma
INTRODUCTION: Early appendicectomy has been found to be a safe and better alternative for management of appendicular mass in various studies in adults, while very few studies report such advantages in the paediatric population. We conducted this study to assess the safety, efficacy and need of early laparoscopic appendicectomy (ELA) in child patients with appendicular mass. MATERIALS AND METHODS: All patients with appendicular mass who underwent ELA at our institute between September 2011 and August 2014 were retrospectively reviewed...
April 2016: Journal of Minimal Access Surgery
Darell Tupper-Carey, Shahridan Mohd Fathil, Yin Kiat Glenn Tan, Yuk Man Kan, Chern Yuen Cheong, Fahad Javaid Siddiqui, Pryseley Nkouibert Assam
INTRODUCTION: A single-centre, prospective randomised clinical trial investigating the analgesic efficacy of the transversus abdominis plane (TAP) block for adult patients undergoing laparoscopic appendicectomy was conducted. METHODS: Patients undergoing urgent laparoscopic appendicectomy under general anaesthesia alone (control group) and general anaesthesia supplemented by the TAP block (TAP intervention group) were compared. All patients received a multimodal analgesia regime, which included postoperative morphine via a patient-controlled analgesia device...
April 8, 2016: Singapore Medical Journal
Tarig Abdelrahman, Jennifer Long, Richard Egan, Wyn G Lewis
OBJECTIVE: Certification of completion of training in general surgery requires proof of competence of index operations by means of 3, level-4 consultant-validated procedural-based assessments. The aim of this study was to examine the relationship between index operative experience and competence. DESIGN: Higher surgical trainee procedural-based assessments were compared with e-logbooks to determine the relationship between index operative experience and achievement of a third level 4 competence (L4C) related to the indicative procedures of emergency laparotomy (EL, target 100), Hartmann procedure (5), appendicectomy (80), segmental colectomy (20), laparoscopic cholecystectomy (50), and inguinal hernia (80)...
July 2016: Journal of Surgical Education
Marianna Zukiwskyj, June Tun, Shashank Desai
A common indication for laparoscopic mesenteric lymph node biopsy is to provide a tissue diagnosis in the absence of palpable peripheral nodes via a minimally invasive approach.  There are no reports to date of ischaemia to the appendix as a complication of this procedure.   We report the case of a 34-year-old lady who underwent a mesenteric biopsy for a lesion found incidentally on CT to investigate longstanding abdominal pain, and 2 days later required an appendicectomy for ischaemic appendicitis.
2016: F1000Research
H Nageswaran, A Maw
No abstract text is available yet for this article.
March 2016: Annals of the Royal College of Surgeons of England
Sanjay Marwah, Kapil Dev Shivaran, Jyotsna Sen, Nisha Marwah
With increasing use of laparoscopy for various surgical procedures, the occurrence of port site tuberculosis is seen more often as a postoperative complication. However, lack of awareness of this entity leads to prolonged morbidity and repeat surgical interventions. In case of nonhealing sinus following laparoscopic surgery, keeping this possibility in mind will lead to early diagnosis and treatment. In recent times, various diagnostic tests have come up for confirming the diagnosis of tuberculosis.
December 2015: Indian Journal of Surgery
A N Sridhar, M Andrikopoulou, L Clarke, C Ashley, P Mekhail, U A Khan
The diagnosis of appendicitis is based on clinical picture. The aim of this retrospective study was to analyse variation of outcomes and impact of increasing use of radiological investigations and laparoscopy over a 5-year period. A retrospective audit of appendicectomies over the last 5 years (01 January 2007-31 December 2011) was conducted. The negative appendicectomy rate (NAR), perforation rate and complication rate were used as outcome endpoints. A statistical analysis was performed to evaluate the difference in outcomes with surgical approach and use of radiology...
December 2015: Indian Journal of Surgery
Mayank Baid, Manoranjan Kar, Utpal De, Mrityunjay Mukhopadhyay
Laparoscopic procedures for removal of the appendix by the three-port technique as an alternative to conventional appendicectomy have gained wide popularity, but they have been criticized for technical difficulty, more time consumption, and high cost. We have compared conventional three-port laparoscopic appendicectomy (LA) and laparoscope-assisted appendicectomy (LAA). In period from August 2010 to January 2012, 77 patients underwent appendicectomy by a minimally invasive procedure (39 LA and 38 LAA), at Medical College and Hospital, Kolkata...
December 2015: Indian Journal of Surgery
Khalid Hussain, Aimel Munir, Madiha Saeed Wahla, Muhammad Amer Mian, Jovaria Masood
Primary Segmental Infarction (PSI) of the greater omentum is rare. It usually presents as acute appendicitis and the diagnosis is made per operatively. We report a case of 22 years male who presented with history and clinical features suggestive of acute appendicitis. Laparoscopic appendicectomy was planned but during diagnostic laparoscopic phase, omentum was found infarcted in the right lower abdomen and the appendix was normal. Laparoscopic omentectomy of the infarcted segment was done and the patient had smooth recovery...
October 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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