ABSTRACT
STUDY OBJECTIVE: To evaluate the efficacy of laparoscopy in confirming the diagnosis of acute appendicitis, to distinguish between acute surgical and gynecologic pathology, and to establish indications for surgical intervention. DESIGN: Assessment of 1000 consecutive emergency diagnostic laparoscopies. SETTING: A state university hospital in Moscow, Russia. PATIENTS: One thousand women with suspected appendicitis. INTERVENTIONS: Diagnostic laparoscopies performed under local anesthesia in all 1000 women, followed by open surgery in 405. MEASUREMENT AND MAIN RESULTS: Laparoscopy confirmed acute appendicitis in 282 of 1000 women and acute gynecologic diseases in 433. Laparoscopic diagnosis of appendicitis was incorrect in only nine women. The only serious complication of laparoscopy was perforation of the small bowel, which was due to dense adhesions in the abdominal cavity in a woman who had undergone several earlier surgeries. CONCLUSIONS: Diagnostic laparoscopy under local anesthesia was very useful in women with acute appendicitis and gynecologic diseases. It was associated with few complications, was inexpensive, and was well tolerated by the patients.
