Non Absorbable Clips vs Endoloops in Laproscopic Appendicectomy

A Comparison Between Non Absorbable Polymeric Clips and Endoloop Ligatures in Securing Appendicular Stump in Laparoscopic Appendicectomy at Assiut University Hospital

a) Compare between Nonabsorbable Polymeric Clips and Endoloop ligatures regarding: technical difficulties. operation time. cost effectiveness. postoperative complications. 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.

Time of application of endoloop, polymeric clip measured from introducing of instruments to cutting the base of appendix

Inclusion Criteria: . Able to give informed consent for inclusion in the study Age of the patient : Any age Exclusion Criteria: • Intraoperative decision to convert to open appendicectomy Primary open appendicectomy Unable to give informed consent for participation in the study

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