From the Research
Approximately 25% of appendectomies are currently performed using the open surgical technique in the United States, with the majority being performed laparoscopically. The most recent and highest quality study, published in 2025, found that laparoscopic appendectomy has become the preferred approach for most cases, with open appendectomies typically reserved for specific clinical scenarios such as complicated appendicitis with abscess or perforation, patients with extensive previous abdominal surgeries that make laparoscopy challenging, hemodynamically unstable patients requiring rapid intervention, or when laparoscopic equipment or expertise is unavailable 1.
The benefits of laparoscopic appendectomy include shorter hospital stays, decreased post-operative pain, lower wound infection rates, and faster return to normal activities, as demonstrated in several studies 2, 3, 1, 4. However, surgeons maintain proficiency in the open technique as it remains an essential skill for certain clinical situations and when conversion from laparoscopic to open approach becomes necessary during surgery.
Some key points to consider when deciding between open and laparoscopic appendectomy include:
- The patient's overall health and medical history
- The severity of the appendicitis
- The availability of laparoscopic equipment and expertise
- The potential risks and benefits of each approach
It's worth noting that the shift toward laparoscopic appendectomy has occurred over the past few decades due to its associated benefits, and it is now considered the gold standard for surgical treatment of acute appendicitis 1. However, the decision to perform an open or laparoscopic appendectomy should be made on a case-by-case basis, taking into account the individual patient's needs and circumstances.
In terms of the percentage of open appendectomies performed, a study published in 2025 found that approximately 52.5% of appendectomies were performed openly, while 47.5% were performed laparoscopically 4. However, this study was retrospective and may not reflect current practice. A more recent prospective study found that laparoscopic appendectomy was performed in approximately 75% of cases, with open appendectomy being performed in approximately 25% of cases 1.
Overall, the choice between open and laparoscopic appendectomy should be based on the individual patient's needs and circumstances, and should take into account the potential risks and benefits of each approach. Laparoscopic appendectomy is generally considered the preferred approach for most cases, due to its associated benefits and lower complication rates.