TITLE:
Evaluation of Handmade Extra-Corporeal Loop versus Metallic Clips in Securing the Appendicular Stump in Laparoscopic Appendicectomy
AUTHORS:
Mohamed Yousef A., Abdallah M. Taha, Asmaa Gaber R., Mahmoud Abdelhameid, Mohammed A. Omar, Mohamed Abdelshafy
KEYWORDS:
Clipping of Appendicular Stump, Endoloops, Handmade Loop
JOURNAL NAME:
Open Access Library Journal,
Vol.3 No.10,
October
31,
2016
ABSTRACT: Introduction: Laparoscopic appendicectomy has gained popularity due to the advantages of minimal-access surgery. Inadequate closure of the appendix stump leads to intra-abdominal surgical site infection or even fecal fistula. The base of the appendix can be secured with endostapler, endoloops, metallic clips or intracorporeal ligature. Aim: To evaluate the handmade extra-corporeal loop versus endoclip in securing the base of the appendix in non-complicated acute appendicitis. Methods: During the period from April 2014 to February 2016, in South Valley University, Aswan University and Sohag University hospitals (these are tertiary hospitals), 400 laparoscopic appendicectomy patients were included in this prospective study. In total, 240 patients were female and the overall average age was 25.6 years old. Patients were divided into two equal groups (group L and group C): in group L, handmade extracorporeal loop was used to secure the base of the appendix, the metallic clip was used in group C.Results: The mean operative time was 49 min in group L and 35.4 min in group C (P 0.05). Complications varied between port- site wound infection and delayed intestinal sounds, fecal fistula and there were no statistically significant differences. Conclusion: Using extracorporeal handmade loop or the metallic clips to secure the appendicular stump is safe, feasible, easy and inexpensive methods. The loop takes a little more time in its preparation. Metallic clips are inappropriate for edematous wide base appendix.