a) Compare between Nonabsorbable Polymeric Clips and Endoloop ligatures regarding: 1. technical difficulties. 2. operation time. 3. cost effectiveness. 4. postoperative complications. 5. inpatient stay.
Laparoscopic appendectomy is gradually evolving as the 'gold standard' in the treatment of acute appendicitis, especially in the obese, elderly, and in cases where the diagnosis is uncertain . There are clear benefits with the laparoscopic approach in terms of decreased pain and faster recovery than the open approach . However, disadvantages like a higher incidence of intra-abdominal collection, longer operating time, and higher costs have been documented. These may be dependent on the technique of appendicular stump closure. Therefore, the technique for appendiceal stump closure is crucial in laparoscopic appendectomy. Laparoscopic appendectomy was first described by Semm in 1983 and is currently preferred approach for an appendectomy for many surgeons. Numerous methods of stump closure have been used, like intracorporeal suturing of the stump endoloop application, endostapler application LigaSure customized titanium clip application, and, more recently, using nonabsorbable plastic clips . Many of these techniques are either time consuming or expensive, or not available universally.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
a method to secure appendicular stump
a method to secure appendicular stump
Operative time
Is there difference in the overall operating time between the two cohorts
Time frame: intraoperative
Complications
Is there a difference in the rate of intraoperative and postoperative complications
Time frame: 30 days
Length of hospital stay (postoperative)
Is there a significant difference in the length of postoperative stay between the two cohorts
Time frame: Up to 14 days
Readmission to hospital
Is there a difference in the thirty day readmission rates between the two cohorts
Time frame: 30 days
Time of Application
Time of application of endoloop, polymeric clip measured from introducing of instruments to cutting the base of appendix
Time frame: 120 min
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