The effect of stump ligation techniques on operative time in laparoscopic appendectomy

Abstract

IntroductionWe aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy.Material and methodsThe patients who underwent laparoscopic appendectomy in our General Surgery Clinic between January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation techniques used in the operations on operative times were evaluated.ResultsSixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracorporeal knotting – loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference between the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time (p < 0.05).ConclusionsWe can speculate that hem-o-lok clip among the stump ligation techniques reduces the cost, is a safe method and shortens the operative time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treatment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other techniques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.