Saurabh Gandhi, MS1, Eham Arora, MS1, Gagandeep Talwar1, Chintan Patel, MS2, Ajay Bhandarwar, MS, FMAS, FIAGES, , FLCS, FBMS, FICS1, Tina Gandhi, MS1. 1Grant Govt. Medical College & Sir JJ Group of Hospitals, India, 2Kiran Multi-Super Speciality, India
OBJECTIVE: In laparoscopic appendectomy, the base of the appendix is usually secured by applying a roeders knot. The aim of this study was to compare the advantages of using staplers and hem-o-locks for securing the base of the appendix.
METHOD: The study included 82 patients between age of 12 to 75 years with acute appendicitis randomly divided into two groups. In the first group, the base of the appendix was secured using roeders knot. In the second group, mesoappendix was not dissected and was included in the endostapler jaws. The primary outcome was overall morbidity. Secondary outcomes were total duration of surgery, total length of stay and ease in difficult cases.
RESULT: No morbidity was recorded in any group. The time of the operative procedure was significantly longer in the cases with roeders knot than in the Stapler group (P<0.0001) as mesoappendix was not dissected in the later. 2 cases with unhealthy base were progressed to laparoscopic quadricolectomy. Apart from the ease of applying a stapler, cases of second group with gangrenous base were easily tackled using endostapler, avoiding the need of a hemicolectomy.
CONCLUSION: All forms of closure of the appendix base are acceptable, but endostapler technique apart from providing a secure base, reduces operative time and is an essential tool in cases of gangrenous base.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87295
Program Number: P226
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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