Robotic appendectomy in gynaecological surgery: Technique and pathological findings

Background: We evaluated the feasibility, safety and pathological findings of incidental robotic appendectomy in patients undergoing robotic gynaecological surgery. Methods: Retrospective analysis of 107 consecutive cases of robotic appendectomy done in conjunction with other robotic gynaecological procedures between May 2004 and January 2007. Results: All appendectomies were performed robotically in conjunction with other robotic procedures. Mean time for appendectomy was 3.4 min. No perioperative complications related to appendectomy were encountered. Among 90 patients with no gynaecological malignancy, 57 patients reported chronic pelvic pain preoperatively and 21 (37%) of them had an abnormal appendiceal pathology as compared to only 5 (15%) of the 33 patients with no pelvic pain (OR. 3.2; 95% CI, 1.1-9.7, p = 0.032). Of seven patients with ovarian malignancy, three (42%) had appendicular metastasis. Conclusion: Incidental robotic appendectomy can be performed safely without the need for switching to conventional laparoscopy. It should be considered in patients undergoing robotic pelvic surgery for pelvic pain and ovarian malignancy.