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ORIGINAL ARTICLE
Year : 2014  |  Volume : 33  |  Issue : 3  |  Page : 188-193

Evaluation of intracorporeal knotting and metallic clipping of the appendicular stump in laparoscopic appendicectomy


General Surgery Department, Faculty of Medicine, Minoufiya University, Shibin Al Kom, Egypt

Correspondence Address:
Hady S Abou Ashour
Faculty of Medicine, Minoufiya University, Shibin Al Kom
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1121.141908

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Background Laparoscopic appendicectomy has gained popularity, especially among laparoscopic surgeons, due to the advantages of minimal-access surgery and the simplicity of the technique. Together with endoloop, various techniques have been tried to secure the base of the appendix. Some laparoscopic surgeons apply ligature or clips owing to its lower cost and feasibility. In this study, we applied intracorporeal ligature (knotting) or metallic clips for secure closure of the base of the appendix during laparoscopic appendicectomy. Aim The aim of this work was to evaluate the application of both techniques, together with recording of any specific complications related to each. Patients and methods During the period from February 2010 to November 2013, in Minoufiya University Hospital and other private hospitals, 200 laparoscopic appendicectomy patients were included in this prospective study. In total, 117 patients were female and the overall average age was 27.4 years. Patients were divided into two equal groups (group A and group B): group A underwent intracorporeal knotting of the base and the metallic clip closure technique was the alternative in group B. Results The mean operative time was 45 min in group A and 37 min in group B (P < 0.05). The mean hospital stay was 2.07 days in group A and 2 days in group B, and this was not significant (P > 0.05). Complications varied between port-site wound infection and delayed intestinal sounds, and there were no significant differences or major complications. Conclusion In our study, both intracorporeal knotting and the metallic clip closure technique were successful, feasible, and economic in securing the appendicular stump, except for a wide, severely edematous, or gangrenous base, wherein the metallic clip closure technique was not appropriate.


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