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A Prospective Study Comparing Appendiceal Stump Closure Techniques with Liga Clips v/s Hem-o-Lok in Laparoscopic Appendectomy: Our Experience at a Single Institute

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Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Purpose

Closure of appendiceal stump (CAS) is one of the most crucial steps in laparoscopic appendectomy (LA) because inappropriate closure of stump may lead to stump leak further causing life-threatening complications like enterocutaneous fistulas, postoperative peritonitis, and sepsis. Recent studies have established the use of endoclips to be simpler and quicker as special laparoscopic skills are not required and hence seamlessly adapted. This study further aimed to compare the results of application endoclips like Liga Clips and Hem-o-Lok for CAS in LA in cases of Appendicitis without complications.

Methods

It is a prospective study with sixty patients diagnosed with appendicitis without complications and planned for LA in a single institute. They were randomly divided into two groups, A and B, of 30 each using the sequentially numbered opaque sealed envelope (SNOSE) method. Liga Clips were used for CAS in group A and Hem-o-Lok in group B. Operative time and intraoperative and postoperative events were recorded.

Results

The mean operative time (time from skeletonization of appendix to retrieval of the appendix) in group A was noted to be 376.03 s (6.27 min) and that in group B was noted to be 345.50 s (5.75 min) (p = 0.2873). No patient developed stump leak or intra-abdominal abscess or had to undergo reoperation in either of the groups.

Conclusion

In conclusion, the use of both endoclips like Liga Clips and Hem-o-Lok for closure of appendiceal stump in laparoscopic appendectomy is a quicker, safe, secure, and feasible technique in cases of appendicitis without increased risk of complications. In our experience, it is suggested that Hem-o-Lok is more efficient in securing the appendiceal stump due to its lock engagement system giving a sense of security and ease of application.

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References

  1. Bozkurt MA, Ünsal MG, Kapan S, Kankaya B, Kalaycı MU, Alış H. (2014) Two different methods for appendiceal stump closure: metal clip and Hem-o-lok clip. J Laparoendosc Adv Surg Tech A (8):571–3.

  2. Elshoura A, Hassan O, Saber S (2017) Application of different methods for stump closure in laparoscopic appendectomy - Egypt J Surg [Internet]. [cited 2019 Aug 25]. Available from: http://www.ejs.eg.net/article.asp?issn=1110-1121;year=2017;volume=36;issue=2;spage=131;epage=136;aulast=Elshoura

  3. Dixit (2016) A comparison of titanium clips versus Roeder’s knot tying suture in laparoscopic appendiceal stump closure: a 1-year randomized controlled trial study in KLES Dr. Prabhakar Kore Charitable Hospital, Belgaum [Internet]. [cited 2020 Jan 8]. Available from: http://www.ijournalhs.org/article.asp?issn=2542-6214;year=2016;volume=9;issue=1;spage=49;epage=55;aulast=Dixit

  4. Kiudelis M, Ignatavicius P, Zviniene K, Grizas S (2013) Analysis of intracorporeal knotting with invaginating suture versus endoloops in appendiceal stump closure. Wideochirurgia Inne Tech Maloinwazyjne Videosurgery Miniinvasive Tech 8(1):69–73

    Article  Google Scholar 

  5. Beldi G, Vorburger SA, Bruegger LE, Kocher T, Inderbitzin D, Candinas D (2006) Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg 93(11):1390–1393

    Article  CAS  Google Scholar 

  6. Kazemier G, in’t Hof KH, Saad S, Bonjer HJ, Sauerland S (2006) Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg Endosc Interv Tech 20(9):1473–1476

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER), Nehru Nagar, Belagavi, Karnataka, 590010, India

    Pronoti Patil & Abhijit S. Gogate

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  1. Pronoti Patil
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  2. Abhijit S. Gogate
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Correspondence to Pronoti Patil.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Patil, P., Gogate, A.S. A Prospective Study Comparing Appendiceal Stump Closure Techniques with Liga Clips v/s Hem-o-Lok in Laparoscopic Appendectomy: Our Experience at a Single Institute. Indian J Surg 83, 1228–1233 (2021). https://doi.org/10.1007/s12262-020-02650-9

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  • DOI: https://doi.org/10.1007/s12262-020-02650-9

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