[Laparoscopic appendectomy in advanced stages of appendicitis]

The laparoscopic stapling appendectomy (LA) is a safe and efficient procedure for all forms of appendicitis. Overall, LA was performed in 51.8% of 280 patients with advanced appendicitis, in 1998 in more than 85%, due to increasing experience. In these cases, the appendix was dissected in double-staple technique and extracted in an endo-bag. The postoperative outcome was uncomplicated even in advanced appendicitis, a reoperation had to be done in 2 patients (1.4%). Wound infections occurred only in 3.5% of patients with LA compared to 8.2% with open appendectomy, the mortality was 0%.

[Surgical laparoscopy in acute abdomen]

In 582 patients, laparoscopy was performed for acute abdominal pain and symptoms of acute abdomen. It allowed a clear diagnosis in 96% as compared to 42% by sonography and 25% by X-ray. In 134 cases (22%) laparotomy (i.e. unnecessary appendectomy) could be avoided. In 42% surgery could be performed laparoscopically, and 36% required surgery by laparotomy.

[Laparoscopic palliative gastrointestinal operation in inoperable upper abdominal tumors with gastric outlet obstruction]

In the period from June 1994 to February 1997, a laparoscopic gastroenterostomy was carried out without intraoperative complications or mortality. In 12 out of 13 patients with gastric outlet obstruction due to inoperable tumor of the upper GI tract (gastric, gallbladder or pancreas carcinoma). From the above, a total of 4 patients had postoperative complications (30.7%), three of which could be treated without further operation. The average duration of the operation was 130 min (range 70-285 mins) followed by an approximal postoperative hospital stay of 17 days (8-41 days).