Trends and Indicators of Appendectomy in the Northern Region of Brazil: A Comparative Study between the Conventional and Videolaparoscopic Techniques

The appendix is a structure of the large intestine, and its inflammation, termed appendicitis, is commonly caused by lumen obstruction. Treatment includes emergency surgical intervention (appendectomy) and antibiotics. The surgical approaches encompass conventional laparotomy and videolaparoscopy. In Brazil, both are performed within the Unified Health System (Sistema Único de Saúde, SUS, in Portuguese), but regional disparities are evident, particularly in the Northern Region. The current study aims to analyze appendectomy indicators in that region from 2020 to 2024, comparing the two appendectomy techniques. The present is a retrospective, observational, ecological study with a quantitative and descriptive approach. Data were collected from the database of the Department of Information and Computer Sciences of SUS (Departamento de Informação e Informática do SUS, DATASUS, in Portuguese), focusing on appendectomy procedures performed using the conventional and videolaparoscopic techniques between 2020 and 2024. A total of 61,943 appendectomies were recorded in the Northern Region. The conventional technique predominated (99.39%), and 95.87% of the procedures were performed in emergency settings. Videolaparoscopy procedures, although increasing annually, accounted for less than 1% of the cases, mostly concentrated in the states of Pará and Tocantins. Mortality was low, with 139 deaths overall, and only 1 associated with videolaparoscopy. The average length of hospital stay was longer for videolaparoscopy (of 4.2 days), possibly due to limited infrastructure. Hospital expenditure reached R$ 36.8 million, with 99.2% linked to conventional procedures. These findings underscore the need for investment in laparoscopic equipment and training. From 2020 to 2024, appendectomies in the Northern Region of Brazil were predominantly conventional and performed urgently. Despite being safe and increasingly adopted, videolaparoscopy remains underused, revealing structural and technological inequalities in Brazil's public healthcare system.