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Benefit of laparoscopic approach in an appendicular purulent peritonitis

F Costantino, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Sep 2007;07(09). URL: http://websurg.com/doi/vd01en2192

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  • 2007-09-10
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This video is one of a series of laparoscopic appendicectomies and shows the advantage of the videoscopic approach in accessing the entire peritoneal cavity in cases of diffuse peritonitis. Blood tests revealed an inflammatory syndrome in a young woman with a 3-day history of diffuse abdominal pain and fever. Exploration of the abdominal cavity during emergency laparoscopy confirmed the clinical impressions. The authors performed aspiration and lavage of the peritoneal cavity. Thorough assessment revealed the omentum to be concentrated in the right iliac fossa, and gentle dissection uncovered a necrotic, perforated appendix. Dissection of the cecum and appendix was difficult because the tissues were friable and adherent. The usual tissue planes were not present, but the laparoscopic view allowed for a safe approach.