Management of the Normal Appendix during Laparoscopy for Right Iliac Fossa Pain
E Jane H Turner, Robin Lightwood
Citation Information :
Turner EJ, Lightwood R. Management of the Normal Appendix during Laparoscopy for Right Iliac Fossa Pain. World J Lap Surg 2009; 2 (2):15-17.
The advent of laparoscopic surgery raises the question of what to do with a normal appendix at laparoscopy for right iliac fossa pain of uncertain origin. We assess the views of all members of the Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI) via means of a survey. Of 135 responses to the questionnaire 61% of surgeons remove a macroscopically normal appendix and 26% do not. 13% of surgeons do not commit. Of those removing a normal appendix the most common reasons given were the possibility of endoluminal appendicitis (87%) and avoiding future confusion as to whether the appendix had been removed (64%). When asked whether there were sufficient guidelines on this topic 68% said no, 6% said yes and 5% were unsure. 16% said that it was a matter for common sense rather than guidelines and 5% felt that the evidence was contradictory. This study highlights a lack of consensus in the management of a normal appendix found at laparoscopy for right iliac fossa pain and demonstrates most surgeons feel guidelines would be useful. In the absence of guidelines the options may be discussed with the patient before operation.
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