Treatment of Complex Extraperitoneal Appendiceal Abscesses Using a Single-Stage Laparoscopic Transabdominal Pre-Peritoneal Approach: A Description of Technique and Perioperative Care

Abstract

The surgical management of complicated appendicitis, especially when clinical diagnosis has been delayed substantially, can be challenging for the emergency general surgery team. The treatment plan needs to be tailored on an individual basis, with careful evaluation of the preoperative imaging studies, patients' prior intra-abdominal surgery and assessment for potential role of combining laparoscopic techniques with percutaneous interventions and/or open surgery. Herein, we present a clinical case with extensive extraperitoneal collections secondary to misdiagnosed appendicitis, which was treated using a single-stage laparoscopic transabdominal pre-peritoneal (TAPP) approach, bypassing the need for additional interventional radiology procedures or open surgeries, which are the most commonly used approaches in similar cases.