Different Options for Closure of Appendicular Stump in Laparoscopic Appendectomy

Youssef Mohammed, Mohammed; Ibrahim, Samir; Ibrahim, Islam Mohamed; Mogahed, Mohammad Farouk

doi:10.21608/zumj.2020.45696.1965

Different Options for Closure of Appendicular Stump in Laparoscopic Appendectomy

Document Type : Original Article

Authors

¹ General Surgery Department , Faculty of Medicine , Zagazig University , Egypt

² Department of General Surgery, Faculty of Medicine, Zagazig University

³ general surgery department ,faculty of medicine,zagazig university,zagazig, egypt

⁴ general surgery faculty of medicine zagazig university

10.21608/zumj.2020.45696.1965

Abstract

Background:The commonest cause of acute abdomen requiring surgical intervention is acute appendicitis. The classical incision used for appendectomy was Grid iron incision pioneered by McBurny in the 19th century. Laparoscopy had invaded most of the fields of surgery including emergency surgery. Various techniques have been used for securing the appendicular stump, some of which is expensive as endoscopic linear cutting stapler; others are not available in some hospitals as preformed suture loops (endoloops).
Aim:to compare between ligation methods (Intracorporeal, Extra-corporeal or Endoloop ligation) and clip application with their different types (polymeric or titanium) for securing the appendicular stump at Zagazig university hospitals
Methods:90 patients were included in this randomized prospective clinical trial study. The patients were randomly distributed into 2 main groups (A&B): Group A: Ligation Group (54). Group B: Clipping Group (36). Then each group was further subdivided into subgroups.
Results:Intra-operative complications was bleeding in 2 cases of ligation group (A) and 2 cases of clipping group (B) was complicated by intestinal injury and bleeding. Two cases in clipping group (B) converted to ligation methods due to very wide base in which the stump was not secured well with clip application.
Conclusion:All techniques of ligation and clipping were feasible, safe and effective, with the same rate of complications; the only difference was regarding operative time as ligation techniques consume more time.

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