Three Centuries of Appendicectomy

Abstract

Background Save for the contribution of Charles McBurney, who described his eponymous point and the appendicectomy incision, the history of appendicectomy is largely unknown among the medical profession. This review traces the history from the first anatomical depiction of the appendix to the development of open appendicectomy and the recent minimally invasive and non-operative methods. Methods Historical articles, monographs and books containing anatomical descriptions of the vermiform appendix and reports of appendicitis and its surgical treatment were retrieved after searching the PubMed, Google Scholar and Embase databases from their inception to 31 March 2022. Results The first inadvertent appendicectomy was performed during an operation for a groin hernia by Cookesley in 1731, and Mestivier was the first to drain a right iliac fossa abscess, due to appendicitis, in 1757. Krönlein performed the first appendicectomy for acute appendicitis in 1884 but his patient died. The first successful appendicectomy for acute appendicitis leading to patient survival was by Morton in 1887. In 1976, Wirschafter and Kaufman performed an inadvertent colonoscopic appendicectomy and, in 1980, Semm carried out the first laparoscopic appendicectomy. The first appendicectomy via a natural orifice (transgastric) appendicectomy was by Rao and Reddy in 2004. Conclusion This historical review charts the development of surgical knowledge concerning the management of appendicitis, from the first anatomical drawings of the appendix and descriptions of appendicitis to the development of surgical and conservative treatments up to the present day. It also corrects some inaccuracies of attribution in previous historical reviews.

Clinical significance of peri-appendiceal abscess and phlegmon in acute complicated appendicitis patients undergoing emergency appendectomy: A single-center retrospective study

“…[11] Traditionally, the standard treatment for acute appendicitis has been an appendectomy, performed either through open surgery or laparoscopically. [12] However, there is growing interest in nonsurgical management for patients with uncomplicated appendicitis. Several studies have demonstrated the e cacy of antibiotic therapy as a nonsurgical alternative for patients with acute uncomplicated appendicitis, reducing the immediate need for surgery.…”

Does non-operative treatment of appendicitis can replace surgery? - literature overview

“…Interestingly, the literature describes cases of appendix removal using an endoscopic approach -transvaginal, peroral transgastric, and per rectal. [17] Both classical and laparoscopic surgery carry a very low surgical risk, and morbidity and mortality are mainly related to the advancement of appendicitis. [1] Appendix removal surgery can be performed on pregnant women.…”

Minimally Invasive Gastrointestinal Surgery: A Review

“…The mesoappendix was then separated from the appendix, and the base was then wrapped with two Roeder loops. After that, the base was split, and the stump was invaginated using a purse-string suture that was applied laparoscopically, followed by a Z-stitch [36].…”