Current techniques in laparoscopic appendectomy.

An improved technique for laparoscopic appendectomy based on an experience of > 120 cases is presented. This method includes numerous additions to and modifications of previously described techniques and is effective for gangrenous and perforated appendicitis as well as for less severe cases. The most important elements are that (a) it is a safer procedure for attaining insertion of the Veress needle and the primary trocar; (b) it employs electrocautery to separate the appendix from the mesoappendix; (c) an Endosac can be used for removal of the appendix from the abdomen without contamination of the abdominal wall; (d) no laser is necessary; and (e) staples are rarely necessary.