Background: Despite many randomized controlled trials, there are still several important doubts about laparoscopic appendectomy. Longer operative time and greater cost are the two major disadvantages of the laparoscopic technique. Patients and Methods: In current techniques of laparoscopic appendectomy, the appendix is ligated and divided within the abdominal cavity. We have performed 423 laparoscopic appendectomies using an extracorporeal technique during the last 8 years. In this technique, the appendix is delivered to the surface through the cannula, and appendectomy is carried out extracorporally. Results and Conclusion: The extracorporeal technique of appendix removal can be performed as safely and efficiently as the open technique. We report our data on the series of 423 operations, in which we had the encouraging experience that the video-assisted extracorporeal technique is a practical and reasonable alternative to the traditional laparoscopic technique.