L'APPENDICECTOMIA VIDEOLAPAROSCOPICA: TECNICA ED ESPERIENZA DI 250 CASI

The videolaparoscopic approach for appendectomy was suggested many years ago and it has spread widely around the world due to its advantages over the traditional technique. Moreover, the technology reached with the instrumentation makes this operation simple, safe and rapid with adequate training. From October 1991 to December 1993, in the Department of General Surgery of the S. Giuseppe Hospital - Cattedra di Chirurgia Generale of the University of Milan, we performed 250 videolaparoscopic appendectomies. The operating technique is similar to the other authors', but with personal variations. Great number of interventions, 177, were elective and 73 were in emergency. The operation was converted to open procedure in 10 cases (4%) and we had postoperative complications that required a reintervention only in one case (0,4%). All patients had a short postoperative course and an excellent cosmetic result. The videolaparoscopic compared with the laparotomic approach offers a better exploration of the abdominal cavity, allows for easier location of the appendix, reduces the period of inactivity, and also in 'difficult' appendectomies gives an excellent cosmetic result. These advantages are appreciable both in elective and in emergency operations.