Appendicitis Foundation Urges More Doctors to Consider the 'Needlescopic Approach' to Appendectomies

When surgery for acute appendicitis is required, the Appendicitis Foundation yesterday urged more doctors to consider using the “needlescopic” approach or mini-laparoscopic surgery, which uses 2-mm laparoscopic instruments, rather than limiting their options to the conventional laparoscopic appendectomy.

Mini-laprascopic surgery, which involves the visual examination of the inside of the abdomen by means of a needle-like laparoscope (also known as peritoneoscopy), has shown some “key advantages” over the traditional laparascopic appendectomy, said Peter Cambridge, Appendicitis Foundation spokesman.

Cambridge cited a study (authors are Gamal Mostafa, Brent Matthews, et al) by the Department of Surgery of the Carolina Medical Center that compared mini-laparoscopic versus laparoscopic approaches in 36 patients who had undergone appendectomies over a 24-month period. Needlescopic appendectomy was performed in 15 patients while the rest underwent laparoscopic appendectomy.

“The patients who received needlescopic surgery had shorter operations, needed fewer medicines, had shorter hospital stays, required shorter post-operative convalescence and returned to work more quickly (than the patients who underwent laparoscopic appendectomy,” said Cambridge.

Cambridge pointed out study findings that showed “significantly shorter mean operative time (p = 0.02), reduced postoperative narcotics requirements (p = 0.05), shorter hospital stay (p = 0.04), and quicker return to work (p = 0.03)” for the needlescopic group vis-à-vis the laparoscopic group.”

The study also concluded that the needlescopic technique is a safe and effective approach to appendectomy.