Prospective evaluation of laparoscopic appendectomy in women with chronic right lower quadrant pain

STUDY OBJECTIVE: To evaluate the feasibility, safety, histology, and outcome after appendectomy in women undergoing operative laparoscopy for chronic right lower quadrant pelvic pain. DESIGN: Prospective evaluation since January 1992. SETTING: University-affiliated teaching hospital. PATIENTS: Three hundred eighty and 103 patients who underwent operative laparoscopy for chronic pelvic pain and right lower quadrant pain, respectively, over a period of 2 years. INTERVENTIONS: At laparoscopy, appendiceal pathology (endometriosis, adhesions, fibrosis) was noted, and appendectomy was performed in 38 and 62 of the two groups, respectively. RESULTS: The appendectomy rate was 60% (62/103) and 10% (38/380) in the patients with right lower quadrant pain and chronic pelvic pain, respectively. No intraoperative or postoperative complications were encountered. After appendectomy 97% (60/62) of patients reported complete relief of right lower quadrant pain. CONCLUSIONS: Laparoscopic appendectomy is a feasible and safe procedure when performed by experienced surgeons. Appendiceal pathology is prevalent in women with chronic right lower quadrant pain and may be responsible for the pain.