Laparoscopic Apendectomy vs Open Surgery

Dear Ask The Doctor: Last month i suffered with appendicites and the hospital has conducted ultra sound scan and other scans. Next day they had done laproscopy and aswell as open surgery with 9 stitches. when asked why they done 2 surgeries they explained me that laproscopy was not enough as the appendice was very large . so they had gone to open surgery also. 1.Is the size of appendice cannot be known from the tests and scans prior to the operation. 2.cant the doctors decide which type of surgery is necessary prior the operation.

Dear Rajesh: With laparoscopic surgery there is always a risk of conversion to an open procedure because of an inability to safely perform the procedure through the special camera and instruments used. This complication of laparoscopic surgery may happen for several different reasons in the case of appendicitis including rupture of the appendix, inability to visualize the entire operating field, uncontrollable bleeding or anesthetic complication.

The size of the apendix can be seen scans but is still only an estimate, albeit usually a fairly accurate one. The size of the appendix coupled with other factors may prevent a safe removal via laparoscopic and necessitate open surgery instead. Your surgeon most likely opted for open surgery upon realizing that there was greater likelihood of rupture of th eappendix and all its complication if he/she were to continue with the laparoscopic procedure