In those clinical settings where surgical expertise and equipment are available and affordable, diagnostic laparoscopy and LA (either in combination or separately) seem to have various advantages over OA. Some of the clinical effects of LA, however, are small and of limited clinical relevance. In spite of the mediocre quality of the available research data, we would generally recommend to use laparoscopy and LA in patients with suspected appendicitis unless laparoscopy itself is contraindicated or not feasible. Especially young female, obese, and employed patients seem to benefit from LA.
Diagnostic laparoscopy reduces unnecessary appendicectomy in fertile women.
To assess the value of laparoscopy in the accurate diagnosis of appendicitis in women of child-bearing age.
                Prospective randomised trial.
                University hospital, Kuwait.
                100 patients who fulfilled the inclusion criteria between July 1988 and March 1990.
                50 patients were randomised to have diagnostic laparoscopy followed by appendicectomy if necessary, and the other 50 to have immediate appendicectomy.
                Avoidance of unnecessary appendicectomy, length of operating time, and length of stay in hospital.
                19 of 50 patients in the study group did not require appendicectomy (38%). One patient required an emergency operation for an ectopic pregnancy. Of the remaining 30, only 4 of the removed appendixes showed no histological abnormality (13%). There were no complications of laparoscopy.
                Laparoscopy is a safe and effective way of diagnosing acute appendicitis and should be used more often.