ABSTRACT
The first known case of surgical removal of the appendix occurred in 1735 by Claudius Amyand in London. It was not until 1886, however, after Reginald H Fitz read his paper to the first meeting of the Association of American Physicians in Washington DC, that the early surgical removal of the appendix became the standard treatment for appendiceal inflammation.1 For over 100 years, the technique of open appendicectomy remained the gold standard. It allowed a safe, relatively simple way for removal of the appendix and it has been a procedure that new surgical trainees used to acquire basic surgical skills. In the 1990s, a laparoscopic approach to the appendix was popularized and is now often the preferred approach allowing some diagnostic and therapeutic benefits.2 A recent Cochrane review3 cited laparoscopic advantages to be decreased postoperative pain, decreased hospital stay, earlier return to work, and less wound infections, although at the expense of increased intra-abdominal abscesses. However, open appendicectomy remains a valid option especially in centers where laparoscopic expertise is unavailable and where the benefits would be minimal, such as in thin males where there is no diagnostic uncertainty and also possibly in children.4
