Value of improved hanging and fastening method on laparoscopic appendectomy：a report of 35 cases

Abstract

Objective To investigate the value of improved hanging and fastening method on laparoscopic＆amp;nbsp;appendectomy in patients with appendicitis. Methods The clinical data of 35 cases of appendicitis who underwent improved laparoscopic appendectomy via hanging and fastening method were analyzed retro-spectively. Laparoscopic appendectomy was implemented via umbilicus and above the pubic symphysis. Laparoscopy was exchanged above the pubic symphysis and umbilicus as the operation hole,epidural puncture needle with thread was pierced abdominal cavity,tightened the thread,and appendix fixed, then we ligatured and cut off appendix and mesoappendix with external cavity Roeder or internal cavity“O”knot. Results Thirty-five patients were successfully operated. The operative time was 30 - 65 min （mean,40 min）. The blood loss during operation was 5 - 30 ml（mean,15 ml）. There were no compli-cations including incision infection,bleeding or intestinal obstruction. The overall cost reduced about ￥ 1,000 compared with the traditional three-hole laparoscopic appendectomy. All patients were dis-charged and abdominal incision hidden. After 1 - 12 months followed-up,there were no complications in-cluding incision infection,bleeding,intestinal fistula or obstruction. Incision healed well and good cos-metic effect in all patients. Conclusions The concept of sterile should be paid attention to in improved laparoscopic appendectomy via hanging and fastening method. It is safe,feasible and simple. There are many advantagements including hidden incision,good cosmetic effect and lower cost,so it is worthy of clinical application. Key words: Appendicitis; Appendectomy; Laparoscopy; Hanging and fastening; Silk thread knotting; Sterile concept