Breaking boundaries: laparoscopic and endoscopic collaboration in appendectomy

Rev Esp Enferm Dig. 2023 Nov 30. doi: 10.17235/reed.2023.10092/2023. Online ahead of print.

Abstract

Background The combination of endoscopy and laparoscopic assistance is gaining attention due to its minimally invasive approach and the potential to improve the safety of surgical treatment for potential malignant tumors at the base of the appendix. Methods Initially, we attempted an endoscopic resection for a patient with a large adenoma in the ileocecal region, with involvement of the appendiceal orifice. However, due to intraabdominal adhesions, a smooth resection was not possible. Therefore, in collaboration with the surgical team, we proceeded with the laparoscopic release of adhesions followed by endoscopic appendectomy. The surgical site was closed using endoscopic purse-string sutures, and intestinal and intraperitoneal dual drainage tubes were placed. Results The patient had a favorable recovery following the appendectomy, with no adverse complications. One year later, the follow-up endoscopy revealed excellent closure of the surgical site. Conclusions The integration of internal medicine and surgery has become an inevitable trend in the advancement of medical disciplines. The laparoscopic and endoscopic combined surgery enhances the cooperation between internal medicine and surgery, ultimately benefiting the patients. This significant attempt holds the promise of further supplementation and support from additional clinical data.