On the problem of endovideosurgery of appendicular peritonitis

Objective. To evaluate the effectiveness of endovideosurgery in terms of simultaneous diagnosis and treatment of patients with acute destructive appendicitis complicated by peritonitis. Material and methods. The study included 128 patients who underwent laparoscopic appendectomy. All patients underwent a comprehensive examination: ultrasound examination of the abdominal cavity, diagnostic laparoscopy (DL). According to indications, multislice computed tomography (MSCT) Results. Total destructive forms of acute appendicitis — 106 (82.8%), 62 (58.5%) patients with local peritonitis, 27 (25.5%) — diffuse peritonitis, 17 (16.0%) patients — widespread peritonitis. In 7 (6.6%) cases, appendictomy was performed extracorporeally with a minimal degree of trauma using an open approach, but sanitation and drainage were also performed using a laparoscopic approach. Patients were discharged on days 4—5—6; there was suppuration of the insertion point of the umbilical port in 6 (4.7%) patients. Conclusion. The introduction of diagnostic endovideolaparoscopy into the program of the diagnostic and treatment algorithm for acute appendicitis will allow, when confirming the diagnosis, to transfer diagnostic videolaparoscopy to the surgical category. Sanitation of the abdominal cavity using laparoscopic access is an effective method of treating peritonitis of appendiceal etiology. The use of sanitation of the abdominal cavity using a laparoscopic approach made it possible to avoid wide laparotomy in 43 (40.6%) patients. Operations using endovideolaparoscopic technology in the surgical treatment of acute appendicitis and its complications are an effective and promising direction of modern urgent abdominal surgery, which allows one to simultaneously solve the problem of diagnosis and surgical correction of acute appendicitis and its complications.