Conservative cecal surgery sometimes necessary
Especially girls and women of childbearing age benefit from the laparoscopic method. In contrast, the conventional method has advantages when the cecum appendix is very changed, as it often can not be removed laparoscopically or only with great effort.
In this conventional way, the abdominal cavity is opened via a small incision in the right lower abdomen. Then look for the lower pole of the cecum, where the worm appendage is usually found. In some cases there are problems with the search, here the cut may need to be extended. The doctor clamps the afferent vessels and removes the appendix. The remaining stump is sunk by means of a special seam, the so-called purse-string suture, and secured with a second suture.
Subsequently, the surgeon sutures the abdominal wall in layers, occasionally a drainage is placed in the wound area, which allows a discharge of blood and wound secretions. In the case of an abscess (pus cavity) in the area of the appendix, it is opened up and a tube is inserted, which dissipates the wound secretion to the outside.
"Notes": procedure without cuts
"Notes" is the generic term for a technology that has been used in some countries in some cases - it stands for "Natural Orifice Transluminal Endoscopic Surgery", an endoscopic technique in which natural body openings are used to penetrate into the large body spaces, for example the Abdominal cavity to enter and operate in organs lying in it. As reported by the doctors' newspaper on 22 October in its online edition, Berlin surgeons have according to their own information nationwide for the first time a patient a kidney on the vagina removed.
The aim was to save the 44-year-old woman an abdominal incision, wound pain and visible outer scars. The woman was able to return home after only six days. Normally, 17 days were planned for the clinic during such an operation. So far, gallbladders have already been removed via the vagina in Germany.
But not all physicians are convinced of the method: so be given a higher risk of infection, because in order to pull the diseased organ out of the body, must still be placed from the inside a cut in the vaginal area. Since the stomach and the large intestine represent extremely germ-rich environments, the risk of peritonitis in the case of a cut in the body is greater than on the outside of the abdominal wall.
The proof of an advantage for patients could only show long-term studies. In Germany so far in humans gall bladder removal, appendectomies and gastric wall resections were made. A dozen other operations were tested on animals.