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Abstract

Patients and surgeons frequently opt for laparoscopic appendectomy for treatment of acute appendicitis. Clinical studies have shown this approach to be a reasonable alternative to open appendectomy. The objective of the current study was to assess the outcome of laparoscopic appendectomy using three different techniques. The study sample consisted of 150 children with acute appendicitis who underwent surgery at Al-Azhar University Hospitals, Cairo, Egypt, and at Al Mishary Hospital in Riyadh, Saudi Arabia, between October 1997 and October 1999. The patients were allocated to undergo extracorporeal laparoscopic appendectomy, Endoloop laparoscopic appendectomy, or EndoGIA (Ethicon Endo-surgery, Inc., Cincinnati, OH, USA) laparoscopic appendectomy. All patients were assessed for the severity of the disease at baseline using clinical and hematologic indicators. The ages of the children ranged from 7 to 14 years, with a mean of 10 years (SD, 2.14 years). Of the children, 55.3% were female. The results showed that children who underwent laparoscopic appendectomy using the EndoGIA had statistically significant shorter operating times, did not have complications, and had the shortest duration of hospital stay (although duration of hospital stay did not reach the statistically significant level of P > 0.05). Therefore, the study showed that laparoscopic appendectomy using the EndoGIA is the procedure that is most recommended, except for the relatively high cost of the disposable materials. Endoloop laparoscopic technique was the second most preferable procedure, and the least preferred procedure was extracorporeal laparoscopically assisted appendectomy. The major drawback of the last technique is the high frequency of complications. Endoloop laparoscopic appendectomy with a purse-string suture can be performed safely if the EndoGIA is not available.

Suprapubic approach for laparoscopic appendectomy

“…Different techniques have been described to perform LA by different authors. [345678910] Either periumbilical or supra pubic port has been used for placement of telescope. The location for the working ports also varies from right upper quadrant to Mc Burney's point, lower midline and left iliac fosse in standard surgical and laparoscopic texts.…”

“…[2] Different techniques have been described by different authors for LA in respect to port placement, handling the base of appendix, division of mesoappendix and removal of appendix. [345678910] We used the 10-mm umbilical port for telescope and for retrieval of appendix and two 5-mm as working port in supra pubic area below the pubic hair line. There are a lots of published study on result of different approach for laparoscopic appendectomy, in world literature, but there are very few published large Indian studies, analyzing the result of supra pubic approach for laparoscopic appendectomy, in Indian patients.…”

Laparoscopic appendicectomy using endo-ring applicator and fallope rings

“…Although the procedure is easy to perform, they cost about €306 per pack and need a 12-mm port for introduction. [79] Complications with Endo-Stapler have also been reported. [9] In recent years, Ligasure and harmonic scalpel have bee used to secure the base of the appendix and mesoappendix.…”

“…Dealing with the base of the appendix is a crucial step in the entire procedure for which various methods such as Endo-Staplers,[5] Ligasure,[6] Endo-loops,[7] Harmonic Scalpel,[8] etc. are employed.…”

Feasibility and Efficacy of Using Hem-o-lok Polymeric Clips in Appendicular Stump Closure in Laparoscopic Appendectomy

“…These may be dependent on the technique of appendicular stump closure. Therefore, the technique for appendiceal stump closure is crucial in laparoscopic appendectomy [ 4 - 6 ].…”