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Use of laparoscopy in the treatment of acute and chronic right lower quadrant pain.

Laparoscopy and the availability of procedures which can be easily performed through the laparoscope, including appendectomy, alter the surgeon's approach towards the management of right lower quadrant pain, both acute and chronic. Laparoscopy can be utilized in a variety of clinical settings, a number far greater than those patients which would otherwise be considered proper subjects for open appendectomy. Laparoscopy can be diagnostic, therapeutic, and also prophylactic. A two year experience of managing right lower quadrant pain in a rural hospital setting was reviewed; the procedure naturally lent itself to a variety of patients because of its ease, safety, and diagnostic accuracy. Chart review indicates an extraordinary degree of success in alleviating both acute and chronic symptoms; only one patient appears to have recurrent right lower quadrant pain out of our entire group. The use of laparoscopy in this manner creates a paradigm for a type of medical practice that is problem-oriented instead of specialty-oriented. The pathological status of the appendix was not the only factor that predicted patients' clinical response to the procedure.