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The purpose of this audit by ACOI (Association of Italian Hospital Surgeons) was toprovide a snapshot on laparoscopic appendectomy (LA) in Italy.Four hundred and sixty surgicalpractices (for a common standard of behaviour) received an e-mail questionnaire.Response rate was 51.7%. The median number of appendectomies per year is 50-100 for eachpractice. LA is widespread (93%), but performed in less than half of the cases. Night-time is not a limit for most surgeons (59%) and LA is performed by dedicated surgeons (< 30%), equally aged above and below 40 years. The majority ofpractices (48%) adopt an ‘all comers’ policy, including selected elders. Conversion is not standardized, while removal of a normal appendix (in absence of concomitant pathology) ispreferred by most (73%). Bi-polar coagulation and loop are the most used techniques. Extraction is accomplished through an endo-bag, peritoneal washing is not routine, and a drain is utilized only in peritonitis. No significant differences are found in LA diffusion between teaching and community hospitals or in different case-volumes.Higher laparoscopic attitude means larger groups of skilled surgeons, less time constraints, more extensive indications and more inclination towards removal of a normal appendix.