Laparoscopic Appendectomy

Abstract

The first reported case of appendicitis appeared in 1554, when Jean Fernel noted at autopsy the luminal obstruction, necrosis, and perforation of the appendix and cecum [1,2]. Although Fernel was the first to describe this disease state as “perityphlitis,” the cause and treatment of the disease continued to be an enigma for more than 300 years. In 1886, Reginald Fitz conclusively demonstrated, in a study involving 25 patients, that the appendix was the primary site and source of inflammation in perityphlitis [3,4]. In his milestone paper, Fitz endorsed early surgical intervention and appendectomy as imperative for cure, and coined the term appendicitis. In 1889, McBurney presented his successful experience involving early removal of the appendix, and helped to improve the method of early clinical diagnosis with his description regarding McBurney’s point [5,6]. Both Fitz and McBurney s work were instrumental in leading to the advocacy of early operative intervention, which by 1901 proved to reduce the mortality of acute appendicitis from 50% to 15% [2,7,8]. Subsequent advances in anesthesia, antibiotics, surgical techniques, and diagnostic modalities have further reduced the incidence of total morbidity and mortality associated with acute appendicitis to 10% to 20% and 0.18% to 0.8%, respectively [9,10–12].