LAPAROSCOPIC SURGERY IN WOMEN WITH A CLINICAL-DIAGNOSIS OF ACUTE APPENDICITIS

Objectives: To assess the routine use of diagnostic laparoscopy and la paroscopic appendicectomy in women with a clinical diagnosis of acute appendicitis. Methods: Women who presented with a clinical diagnosis o f acute appendicitis between 1 January 1992 and 31 August 1993 were pr ospectively assessed and 107 underwent diagnostic laparoscopy. Results : Appendicitis was confirmed in 63 women (59%) and no diagnosis could be made in seven (6%). An alternative diagnosis, most commonly a gynae cological disorder, was made in 37 women (35%). Twenty-eight women wit h an alternative diagnosis (76%) did not require a laparotomy. Seventy -three patients had a laparoscopic appendicectomy, with an 8% conversi on rate to an open operation. The morbidity rate for laparoscopic proc edures was 3%, the median inpatient stay was two days and the median t ime to return to normal activities was eight days. Conclusions: Diagno stic laparoscopy should be performed in women who present with a clini cal diagnosis of acute appendicitis to confirm the diagnosis, reduce t he rate of unnecessary appendicectomy and avoid an unnecessary laparot omy. When acute appendicitis is confirmed, appendicectomy may be perfo rmed laparoscopically.