ISSN: 2451-0637
Archives of Medical Science - Civilization Diseases
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1/2021
vol. 6
 
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abstract:
Clinical research

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

Nizamettin Kutluer
1
,
Ali Aksu
1
,
Ulaş Aday
2
,
Hakan Burhan Kanat
3
,
Abdullah Böyük
4
,
Serhat Doğan
3

1.
Department of General Surgery, Private Doğu Anadolu Hospital, Elazığ, Turkey
2.
Department of General Surgery, School of Medicine, Dicle University, Diyarbakir, Turkey
3.
Department of General Surgery, School of Medicine, Malatya Turgut Ozal University, Malatya, Turkey
4.
Department of General Surgery, Elazığ Medical Park Hospital, Elazığ, Turkey
Arch Med Sci Civil Dis 2021; 6: e75–e77
Online publish date: 2021/06/30
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Introduction
We aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy.

Material and methods
The 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.

Results
Sixty 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).

Conclusions
We 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.

keywords:

laparoscopic appendectomy, operative time, stump ligation

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