A scarless, surgical procedure for appendicitis, called transgastric appendicectomy, that uses a pinhole incision through the navel may be a feasible alternative to standard appendectomies.
The finding came from a new study that was published in British Journal of Surgery and points to a need for larger studies to test the potential of the procedure.
Transgastric appendicectomy is an experimental, minimally invasive procedure which stays away from the use of external incisions and causes the patient to feel less pain than traditional procedures.
During the surgery, an endoscope is passed through the stomach into the abdominal cavity by an insertion of a needle.
Georg Kaehler, MD, of the University of Heidelberg’s University Medical Centre Mannheim, in Germany, said:
“Surgeons and their patients had good experiences with surgery by pinholes beginning in the 1990s, and there is interest in continuing this development to avoid incisions in the abdominal wall completely and to obviate wound infections and incisional hernias. Therefore we used flexible tubes called gastroscopes to get through the stomach into the abdominal cavity and to perform surgical operations there.”
Fourteen patients were involved in the study who had uncomplicated appendicitis. Transgastric appendicectomy was performed on the subjects by Dr. Kaehler and his colleagues.
The experts said:
“Transgastric appendicectomy was explained to patients who met the inclusion criteria as a new minimally invasive operation that uses only one transumbilical 5-mm incision, but has an unknown risk of complications from the additional gastric incision. Informed consent was then obtained.”
Four days after the surgery, two patients with abdominal inflammation needed cleansing treatments, referred to as lavage.
Hospital stays and complications after surgery were comparable to those of traditional procedures for appendicitis.
Although these results are only preliminary, they indicate that this innovative surgery shows promise, specifically for appendicitis not accompanied by generalized peritonitis.
However, the authors pointed out, more data is necessary on the particular benefits and disadvantages of the method. A multicenter trial is now being planned, according to Dr. Kaehler in his team, who hope to confirm the feasibility and safety of transgastric appendicectomy.
Appendicitis is a condition in which the appendix becomes inflamed, swollen, and filled with pus. At first, a person can experience some pain anywhere in the stomach area, however, as it intensifies, its location becomes more defined in the lower right-hand side of the abdomen.
Common symptoms for appendicitis include:
- loss of appetite
- inability to pass gas
- coughing or sneezing is painful
- progressively worsening pain
A previous study published in The Lancet found that surgery for appendicitis is much more effective than taking antibiotics.
Written by Sarah Glynn