January 23, 1978

Incidental Appendectomy

Author Affiliations

Surgical Associates of the Children's Hospital of Philadelphia Philadelphia

JAMA. 1978;239(4):295. doi:10.1001/jama.1978.03280310027010

To the Editor.—  Statistical analyses have indicated the logic of incidental appendectomy especially in the younger population,1 and that this procedure is practical is confirmed by recommendations by more than half of the training directors in surgery and obstetrics/gynecology.2 If an argument is still made criticizing incidental appendectomy, it usually has as its basis fear of opening an otherwise sterile peritoneal cavity to the potential contamination of the appendiceal lumen, but using inversion-ligation appendectomy negates this problem.Inversion appendectomy was first described in 1895 by Dr George Edebohls,3 and its wide use in obstetrics and gynecology was emphasized more than 60 years later.4 Its application to pediatric surgery was suggested in 19685 and later was modified to the current practice of inversion with ligation of the stump6; this technique has been done in several hundred children of all ages without a known complication at