LAPAROSCOPIC CHOLECYSTECTOMY
Dr. Mehmet KAPLAN
Dept. of General Surgery
Medical Park Gaziantep Hastanesi
Gaziantep, TURKEY
5 Ocak 2008 Cumartesi
Laparoscopic Management of Appendicitis (a video demonstration)
LAPAROSCOPIC APPENDECTOMY
Dr. Mehmet KAPLAN
Dept. of General Surgery
Özel Hatem Hastanesi
Gaziantep, TURKEY
This is a sample video of our laparoscopic appendectomy experience. More than a
thousand of cases were successfully treated with minimal morbidity. There
is only one mortality 2 months after operation, that is not associated with
surgery. When compared with traditional open surgery, laparoscopic approach is
much more comfortable and safe for patients.
Here is the video of different patients with appendicitis treated by laparoscopic surgery.
Dr. Mehmet KAPLAN, Özel Hatem Hastanesi, Gaziantep, TURKEY
VIDEOASSISTED APPENDECTOMY: WHY NOT? Mehmet KAPLAN, MD.
VIDEOASSISTED APPENDECTOMY: WHY NOT?
Mehmet KAPLAN, MD.
Department of General Surgery, Özel Hatem Hastanesi, Gaziantep, Turkey
For Correspondence : Dr. Mehmet KAPLAN
Özel Hatem Hastanesi
Genel Cerrahi Servisi 27100
Gaziantep-TÜRKİYE
Phone : +90 342 2201515
Fax : +90 342 2203222
e-mail : mehmet.kaplan@yahoo.com
ABSTRACT
Purpose: The utility of laparoscopic appendectomy is still controversial because of its high cost, long operative time and associated complications. It is described herein an alternative, simplified technique of two puncture laparoscope-assisted appendectomy using basic laparoscopic equipment, all of which are reusable. Technique: The first trocar is inserted blindly within the umbilicus; the second trocar is inserted under the laparoscopic view in the right inguinal region just below the hair line in order to obtain an excellent cosmetic result. After initial survey of entire peritoneum and confirmation of the diagnosis, appendix is grasped and introduced within the second trocar, entirely exteriorized with it and resected exteriorly as a standard open fashion. The caecum is allowed to return to its normal site and the trocar is reinserted. The dissection sites are controlled by laparoscope for any abnormality. Irrigation and/or drain placement is performed if necessary. Oral intake is allowed after 4-6 hours and the patient discharged in the same or after the day of operation. Discussion: Today, the utility of diagnostic laparoscopy and laparoscopic appendectomy is accepted by almost all surgeons, especially when there is uncertain diagnosis of appendicitis. This technique for delivery of the appendix through the trocar puncture with the aid of video-laparoscopy will be used only when appendix is mobil, otherwise standart three cannula technique should be considered. In conclusion, we recommended this technique as an alternative for standard open and closed appendectomy because of its safety, cosmetic, easy and quickly performed, and not associated with high cost.
Key words: Appendicitis, diagnostic laparoscopy, laparoscopic appendectomy, technique
Mehmet KAPLAN, MD.
Department of General Surgery, Özel Hatem Hastanesi, Gaziantep, Turkey
For Correspondence : Dr. Mehmet KAPLAN
Özel Hatem Hastanesi
Genel Cerrahi Servisi 27100
Gaziantep-TÜRKİYE
Phone : +90 342 2201515
Fax : +90 342 2203222
e-mail : mehmet.kaplan@yahoo.com
ABSTRACT
Purpose: The utility of laparoscopic appendectomy is still controversial because of its high cost, long operative time and associated complications. It is described herein an alternative, simplified technique of two puncture laparoscope-assisted appendectomy using basic laparoscopic equipment, all of which are reusable. Technique: The first trocar is inserted blindly within the umbilicus; the second trocar is inserted under the laparoscopic view in the right inguinal region just below the hair line in order to obtain an excellent cosmetic result. After initial survey of entire peritoneum and confirmation of the diagnosis, appendix is grasped and introduced within the second trocar, entirely exteriorized with it and resected exteriorly as a standard open fashion. The caecum is allowed to return to its normal site and the trocar is reinserted. The dissection sites are controlled by laparoscope for any abnormality. Irrigation and/or drain placement is performed if necessary. Oral intake is allowed after 4-6 hours and the patient discharged in the same or after the day of operation. Discussion: Today, the utility of diagnostic laparoscopy and laparoscopic appendectomy is accepted by almost all surgeons, especially when there is uncertain diagnosis of appendicitis. This technique for delivery of the appendix through the trocar puncture with the aid of video-laparoscopy will be used only when appendix is mobil, otherwise standart three cannula technique should be considered. In conclusion, we recommended this technique as an alternative for standard open and closed appendectomy because of its safety, cosmetic, easy and quickly performed, and not associated with high cost.
Key words: Appendicitis, diagnostic laparoscopy, laparoscopic appendectomy, technique
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