I'm confused - I would think it would be more dangerous cutting a hole in your stomach from the inside. What's wrong with the old fashioned way? Scars are hot (see Padma Lakshmi).

I think the bad times for the appendix began before the operation, when it got infected. This operation is like euthanasia.

Let's hope the doctor knows the difference between an appendix and an testicle!

@Parker. A:
if they were capable of reaching your testicle via your mouth, i think you've lost it already.

I assume this "enhanced" procedure will cost about double the going rate of a traditional appendectomy... Just so one can get back to pizza a couple days later... This is one reason why we have the most expensive health care system in the world as apposed to providing health care for all...

Nice, but can this technique also pull your head out of your ass???

@sfokevin: True. But is the surgery room not chilled down to slow the heart beat and when the core body temperature goes down, the nuts go up. As in, when you sit in front of the puter all night in your boxers with the AC set at 68 degrees!

@Parker. A: I think yo meant Willyolio... I'm a nice low hanger with a toasty warm MacBook in my lap...

feh, in soviet Russia, appendix ruptures you!
im sorry.

Wouldn't it be a shorter trip with more legroom to go through the back door?

No infection? I don't believe that for a second. Any operation can lead to infection. One wrong snip and you've got the equivalent of a ruptured appendix. This is a very interesting approach, though.

@roflwaffles:
"feh, in soviet Russia, appendix ruptures you!
im sorry."

As well you should be.

Cool. While they're in there, can they also go ahead and grab that 50¢ piece I swallowed as a kid? Anything to help defray the cost of the surgery.

In an unrelated story...
(End of Week One: -5)

@sfokevin: It's a bit unfair to say what you say. The real advantages, as mentioned in the article, are that there's no visible scarring and, purportedly, that time to heal is minimized--not everyone wants to "get back to pizza a couple days later."

There are a few ways to look at this:
(-) If adoption of consumer-driven health care plans continues to increase, more people will tend to choose the less expensive surgery (especially if the one mentioned here was "double the going rate of a traditional [procedure]")

(-) This isn't an innovative procedure. While laparoscopic surgery does leave a scar, it is on average about 1-cm in length. (Considering this, it seems less likely that plan coordinators would include this procedure on any reimbursement schedule.)

(-) In terms of the U.S.'s "most expensive health care system in the world," there are other culprits worth mentioning such as administrative costs, regulatory costs, willingness to pay, the uninsured, the "baby boomers", and the overweight. (I know that you mentioned innovation was just one of the reasons for the cost.)

(-) Sometimes, prices need to be high to sustain innovation--at least in terms of pharm goods. Also, consider that U.S. prices help to subsidize the capped prices in other countries for these goods. But I digress...

However, most alarming is the implicit argument you make in your last line. Please correct me if I'm wrong, but are you suggesting that expensive health care and universal health care are mutually exclusive? If we want universal coverage, we need to expect high cost (initially, at least.)

Anyway, this procedure sounds great, but I prefer my laparoscopic scars any day. Would you really want a bag of toxic death exploding inside of you because the surgeon had less operational control? (I know, that's a bit excessive)

I can see how this would be an improvement on the traditional appendectomy (which I had five years ago because my appendix was apparently minutes from bursting by the time they figured out I had appendicitis), but aren't most appendectomies nowadays performed laparoscopically?

You only get a few wee incisions in the stomach and the recovery time is much better than the slice-n-dice method I went through. I feel like that's a hell of a lot less complicated and cheaper than this nonsense.

This procedure is pretty innovative, especially for a school that doesn't have a medical center!
Get your schools straight, Gizmodo.
University of San Diego is a private college with nothing special.
San Diego State University is where that huge drug bust went down last week.
AND University of CALIFORNIA, San Diego is the one with the prestigious medical center.

@dichron:
In Gizmodo's defense, the original article wrote that the procedure was "performed by doctors in San Diego, California."

The article continued by citing "Santiago Horgan, of the University of San Diego Medical Centre."

Anyway, your comment reminds me of when people cry over Penn State != UPenn. It really doesn't matter (that much) because those that need to know the distinction will know it. And, honestly, not that many people need to know!

A degree is a degree. Unless you payed for a doctored degree.

Wouldn't it just be much much easier to go through your colon and not through your mouth since the appendix is closer to your anus. Its connected to the colon. Why drill holes in your stomach and have the risk of acid in your body when you could just have a snake like thing go up your butt and take it out that way?. This way there would only be one scar the one from your appendix that was taken out.

@danielmakman: I suspect the risk of infection through the colon into the abdomen is much much greater.

@Shuft: I suppose it would be shorter if you included a bore to pass through the several metres of intestines.

@bitfactory: Exactly. The Stomach is actually a quite sterile place.

The skin and the intestines, not so much.

Going through the colon would quite certainly cause an infection, sending E-Coli directly into the adbomen. The risk of anything from the stomach would be low, and I would guess they use pepcid or some other H2 blocker to lower the acidity in the stomach before surgery.

@AmbroseP:

Actually the comment about it probably costing double was made by a poster - and isn't mentioned in the original post.

And while, initially, I'm sure it will cost more - because it is different, and so people have to be trained on it.

I'm sure in the long run, it'll cost less. The environment doesn't need to be as sterile (since you're going through the mouth and stomach), and it's less invasive because you're not cutting into the skin (though you are cutting into the stomach - so that might be a wash), and healing time is less.

So, in the long run, I'm sure it'll cost less.

What I'm trying to figure out, is if the average appendix is 10 cm long and about 6 to 7 cm wide - how do they get it out of the 1 cm hole they make when they do it laparoscopically?

@danielmakman: "You could just have a snake like thing go up your butt and take it out"...looks like someone's been watching the director's cut of 'Deliverance',lol

Personally,I had mine removed in Sept.,and they did the laparoscopic surgery. I have a scar less than the size of a penny on my stomach and one "in the bush",and that's it. Was out of the hospital in 2 days. Back to working out in two weeks.

@tidybowl:
Actually, I'm well aware that the "costing double" comment was made by another poster--hence me addressing said poster in my original comment.

And while I was trying to point out that his "double cost" assumption was unfair, I never said that the procedure would cost more (nor did I say it would cost less).

I'm sure it'll cost less in the sense that there will be fewer billed hospital days. That's why I made the "time to heal is minimized" comment. I just forgot to mention that related point! However, in the overall scheme of things, this wouldn't make a huge difference in expenditures.

My whole cost quibble was solely related to health care expenditures (in general) and universal health care.

I apologize if my original post was confusing. I'll try to be more clear next time.

The real benefit of this surgical technique is the ability to perform surgery without piercing the skin, muscle and fascia in order to reach the appendix. Working from an highly acidic environment generally free of pathogenic bacteria should also significantly improve post-op infection rates and decrease time spent in convalescence.

These two factors alone, decreased complications and decreased recovery time, will actually reduce the cost of performing medical procedures because they result in less time spent in the acute care setting (i.e. hospitalization) and less lost productivity due to convalescence.

This is amazing, minimally invasive surgery owns

What if the appendix bursts while they are sucking it up the tube? Then you are screwed and have to be cut open regardless - not to mention flushed with about 200 different drugs/anti-virals etc., and other wonderful things in oder to get rid of the poison stored in the black satchel of death.

27 years late for me... but its ok, i tell the chicks its a scar i got in a knife figth... wich of course i won. ;)

@AmbroseP: I'd pay double without blinking an eye. Not having a scar would make it worth it.

@kmpu-tah: Obviously this wouldn't work for acute appendicitis, or an appendix that bursts during the operation, but given a choice...I'd say go for it. Then if you have to cut me open because it bursts mid proceure....so be it.

@DCGaymer:
Would you pay double or would your insurance pay double? There's a big difference.

Also, have you ever seen any scarring as the result of using a laparoscopic procedure? I had my appendectomy about six years ago and I can barely see the original scars--just my personal experience, though.

@tidybowl: Got the length right, not the width: The appendix is 6-7 millimeters in diameter, not centimeters - even when inflamed. And it's squishy. Remember that they can remove a gall bladder (shorter but rounder) through a similar size hole.

@sfokevin: I know your comment has already been addressed, but once again, innovation may cost more but that's why people fly here from countries where they could get their health care for "free" (well where they've already paid for it with their taxes) to pay for our expensive yet cutting edge health care. You forgot to mention we have one of the BEST health care systems in the world. And innovation, and investment in innovation, is what's gotten us that system.

So they'd have to cut a big enough hole in the stomach to get the appenidx thru_

They have to also sew up the hole that was cut in the stomach_

And then yore gonna have a nasty after taste when you wake up from tasting yor own appenidx_

They should drag doen a little salt and butter with the cutting tools and bag before they pull it back thru yore mouth_

@AmbroseP: I would pay whatever the cost to not have a scar. I've got enough of those from childhood.

@uberfu: Maybe we could have some mint jelly on the side.

@tidybowl: since the initial path is going down the throat into the stomach - that's one thing - but they are still cutting into the internal space inside your body and there would have to be sterility there - seeing as how your appendix and stomach do not actully reside side by side or are attached to each other_

Stomach Acid adrift on the surgery instruments while inside the free space of a body does not sound like a good thing to me_ Not mention anything else that lurks in your stomach or food pipe_ Bacteria and what not_

@DCGaymer: whatever makes it taste better_

The Doc could give you a menu of flavors before you go under_

@DCGaymer:
I feel like you're avoiding the question.

Assume that the cost of a laparoscopic appendectomy is $13,000 (we'll ignore the cost of open wound infection--it should be lower compared to an open procedure anyway), and that this "new" procedure would cost $21,000.

Also, assume that, if you do have insurance, hospital days will be covered; insurance will pay 90% of the cost of current appendectomy methods; or, they will pay up to 50% of the cost of a procedure that's not preferred.

You're telling me you'd rather pay $10,500, out of pocket, for no scars than pay $1,300 and end up with two or three tiny scars?

I'm just trying to see if you would really prefer this "new" approach.

Dudes. It's surgery. The primary goal of medicine is less risk and better health, not lower cost. (that can be a goal of some new procedural development, but it is trumped by a more healthy procedure) It's not like they're going to present a menu and let people choose from the "value menu", with the knowledge it comes with more rehab and a little more risk. Sure their are different options sometimes for given surgery, but if a new procedure is found that is better for the patient, ... they'll use that one in the place of old procedures.

Oh, and I have to smile at some people commenting on a tech blog that second-guess extremely educated doctors/surgeons. That'd be like commenting on space shuttle heat panels ..."I don't know ..(grabs another Funyon)... I think they need more panels. (chomp, chomp) That just doesn't seem like enough."

And yes, I do so love Funyons.

@sonofray:
That naive outlook is partly responsible for the current state of health care in the United States.

Physicians entrusted with so much responsibility oftentimes are pained with juggling quality, cost and access--all of which can have both direct and indirect impacts on a patient's mental and physical health. Physicians do not need this burden, but at the same time, an antiquated system will not adequately handle it.

So, while I agree with you on the idea that medicine should be health-centric, I add that there are many other factors to take into account.

Also, nowhere does it say that oral appendectomy is less risky and results in better health (I noticed you never made an explicit reference to this specific surgery, so my apologies if this isn't what you meant). That, however, is mainly because the procedure is in it's infancy. Only time (and maybe the animal model studies) will tell--unfortunately.

Finally, you should be careful about misjudging the people on any forum. You might actually be surprised about the diverse educational and experiential backgrounds people have. The ability to enjoy a good 'pantsing' and know things aren't mutually exclusive.