Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age


Aim: To see whether laparoscopy improves the accuracy of a clinical diagnosis of acute appendicitis in women of reproductive age, and to determine what the long-term sequelae are of not removing an appendix deemed at laparoscopy to be normal. Method: The initial part of the study was undertaken during 1991–1992. Female patients between 16 and 45 years were eligible for inclusion once a clinical decision had been made to perform an appendicectomy for suspected acute appendicitis. Following consent, patients were randomized into two groups. One group had open appendicectomy, as planned. The other group had laparoscopy, followed by open appendicectomy only if the appendix was seen to be inflamed or was not visualized. The end points for the study were the clinical outcomes of all patients, and the results of histology, where appropriate. An attempt was made to contact all patients at 10 years to determine whether they had had a subsequent appendicectomy, or had been diagnosed with another abdominal condition that might be relevant to the initial presentation in 1991–1992. Results: Laparoscopic assessment was correct in all cases in which the appendix was visualized. Diagnostic accuracy was improved from 75% to 97%. Laparoscopy was associated with no added complications, no increase in hospital stay in patients who went on to appendicectomy, and a reduction in hospital stay for those who underwent laparoscopy alone. No patients developed a problem over the 10-year follow-up period from having a normal-looking appendix not removed at laparoscopy. Conclusion: Laparoscopic assessment of the appendix is reliable, and to leave a normal-looking appendix at laparoscopy does not appear to cause any long-term problems.

This is a preview of subscription content, log in to check access.


  1. 1

    REB Andersson (2001) ArticleTitleSmall bowel obstruction after appendicectomy. Br J Surg 88 1387–1391 Occurrence Handle10.1046/j.0007-1323.2001.01869.x Occurrence Handle1:STN:280:DC%2BD3Mrjt1SmsQ%3D%3D Occurrence Handle11578297

  2. 2

    B Dijkstra PF Bagshaw FA Frizelle (1999) ArticleTitleProtective effect of appendectomy on the development of ulcerative colitis. A matched case control study. Dis Colon Rectum 42 334–336 Occurrence Handle1:STN:280:DyaK1M3jvValug%3D%3D Occurrence Handle10223752

  3. 3

    R Dubois A Bouhafs G Pelizzo P Carlioz AF Valmalle H Dodat (2001) ArticleTitleA new technique of bladder enlargement and continent urinary diversion using the ceco-appendicular unit. Pediatr Surg Int 17 578–583 Occurrence Handle10.1007/s003830000543 Occurrence Handle1:STN:280:DC%2BD3MrmsVSjtA%3D%3D Occurrence Handle11666067

  4. 4

    A Fingerhut B Millat F Borrie (1999) ArticleTitleLaparoscopic versus open appendectomy: time to decide. World J Surg 23 835–845 Occurrence Handle10.1007/s002689900587 Occurrence Handle1:STN:280:DyaK1Mzks1arsA%3D%3D Occurrence Handle10415210

  5. 5

    PG Larsson G Henriksson M Olsson J Boris P Stroberg SE Tronstad S Skullman (2001) ArticleTitleLaparoscopy reduces unnecessary appendicectomies and improves diagnosis in fertile women. A randomized study. Surg Endosc 15 200–202 Occurrence Handle10.1007/s004640000255 Occurrence Handle1:STN:280:DC%2BD3Mvit1Ggug%3D%3D Occurrence Handle11285968

  6. 6

    RW Robertson AC Lynch SW Beasley PN Morreau (1999) ArticleTitleEarly experience with the laparoscopic ACE procedure. Aust NZ J Surg 69 308–310 Occurrence Handle10.1046/j.1440-1622.1999.01554.x Occurrence Handle1:STN:280:DyaK1M3lslSmtw%3D%3D

  7. 7

    S Sauerland R Lefering EAM Neugebauer (2001) Laparoscopic versus open surgery for suspected appendicitis (Protocol for a Cochrane Review). The Cochrane Library, Issue 4. Update Software Oxford

  8. 8

    WT Van den Broek AB Bijnen P de Ruiter DJ Gouma (2001) ArticleTitleA normal appendix found during diagnostic laparoscopy should not be removed. Br J Surg 88 251–254 Occurrence Handle10.1046/j.1365-2168.2001.01668.x Occurrence Handle11167876

  9. 9

    HT Wang HC Sax (2001) ArticleTitleIncidental appendectomy in the era of managed care and laparoscopy. J Am Coll Surg 192 182–188 Occurrence Handle1:STN:280:DC%2BD3M7ktlSnsA%3D%3D Occurrence Handle11220718

Download references

Author information

Correspondence to F. A. Frizelle.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

van Dalen, R., Bagshaw, P., Dobbs, B. et al. The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age . Surg Endosc 17, 1311–1313 (2003).

Download citation


  • Laparoscopy
  • Appendicitis
  • Randomized controlled trial