INTRODUCTION OF INTRAOPERATIVE IRRIGATION TO LAPAROSCOPIC APPENDECTOMY

概要

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To date there is no consensus on the necessity of intraoperative irrigation in laparoscopic appendectomy. At our hospital, laparoscopic appendectomy is indicated in all cases of acute appendicitis for which appendectomy is performed. Using a high-speed irrigation device that allows intraoperative massive irrigation, we perform intraoperative irrigation in all cases of appendectomy. In cases in which intraoperative inflammatory ascites is evident, intraoperative irrigation is performed with 10 L of warm saline; in other cases, 5 L is used. We insert the trocar on the right side in the cases with 10 L and on the left side in cases with 5 L of warm saline. We insert a drain into the cul-de-sac in all cases and remove the drain the following day. A total of 92 cases were studied. Histologically, 7 cases were catarrhal, 41 cases were phlegmonous, and 44 cases were gangrenous. No postoperative complications occurred in any of the cases. Here, we describe our technique of intraoperative massive irrigation.