Archive for Tuesday, April 14, 1992


April 14, 1992


Laparoscopy, a less intrusive surgical technique than traditional procedures, has caught on in Lawrence, and a local physician says applications for the technique are "wide open.''

Recently, local general surgeons began doing laparoscopic appendectomies to treat patients with acute appendicitis.

Laparoscopy is the examination of abdominal structures by means of an illuminated tubular instrument, called a laparoscope, which is passed through a small incision in the wall of the abdomen.

The main advantage of laparoscopy, which was used in gynecological procedures for many years before being applied to general surgery, is that the technique is less intrusive.

Laparoscopic surgeries involve three small abdominal incisions through which the surgery is conducted with stapling and cutting tools. Such surgeries take about 40 minutes. Recovery is faster, so patients often can return to work sooner.

ACCORDING to information provided by Dr. Dale Denning, a local general surgeon, Kurt Semm from Germany reported the first case of an appendix removed solely with laparscopic methods in 1983. Denning said in a recent interview that laparoscopic appendectomies have been performed more frequently since 1987, when the first report about laparoscopic surgery for acute appendicitis was published.

He said local physicians probably had performed 12 to 15 laparoscopic appendectomies since February. He added that appendectomies were one of the most common surgical procedures in the United States.

Denning also said he thought applications for laparoscopy were "wide open," noting the procedure definitely benefited patients although it was more difficult to perform than traditional surgeries.

"The big impact is getting back to work sooner," Denning said. "The post-operative pain is less than with the old way."

Another advantage Denning noted is that acute appendicitis is not always the problem. With laparoscopy, the surgeon can examine the patient more thoroughly before going ahead with surgery, he explained. The patient's pain may be due to something else, and with the laparoscope, that's easier to determine.

SYMPTOMS of acute appendicitis can include pain, anorexia, nausea, vomiting, constipation and diarrhea.

If left untreated, a diseased appendix eventually will rupture, Denning said, noting the rupturing creates a potentially life-threatening condition.

Acute appendicitis typically occurs in people between the ages of 10 and 30 years. An article provided by Denning said that among teen-agers and young adults, the ratio of males to females who experience the condition is 3 to 2. After age 25, the ratio gradually declines until the gender ratio is equal by the mid-30s.

Denning stressed that laparoscopy was not laser surgery and that although laparoscopic appendectomies had proved quite successful, they were not for everyone.

He said people who, as a consequence of previous surgeries, have a lot of scar tissue were not good candidates for laparoscopic appendectomies. Obesity and "other marked medical problems" may disqualify someone for the surgery as well, he added.

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