Endoclips Versus Intracorporeal Ligatures In Laparoscopic Appendectomy For Uncomplicated Appendicitis

Abstract

Background: Acute appendicitis is a primary cause of acute abdominal pain & the most prevalent surgical emergency necessitating urgent intervention. Appendectomy is one of the most frequently carried out emergency techniques. This research aimed to compare endo-clips with intra-corporeal ligatures in the closure of the appendiceal stump through laparoscopic appendectomy.

Methods: Eighty-four cases identified with appendicitis were retrospectively recruited for randomized research from March 2023 to November 2024. The patients have been divided into two equal groups: Group A had laparoscopic appendectomy with endoclips for securing the appendiceal stump, whereas Group B utilized a ligature for the same purpose. The evaluation of both methods focused on safety, efficacy, operative time, and complications.

Results: Our study found no significant variances in demographic characteristics or preoperative comorbidities among the clip and ligature groups. Operative time was significantly shorter in the clips group (mean ± SD: 50.02 ± 10.71 minutes) compared to the ligature group (mean ± SD: 56.42 ± 9.51 minutes), with a p-value of 0.005. Complication rates were comparable among groups, with no significant differences in intraoperative bleeding from the mesoappendix (p = 0.645), bleeding from the port site (p = 0.557), or post-operative ileus (p = 0.645). Additionally, hospital stay didn’t vary significantly among the groups (p = 0.649), indicating comparable postoperative recovery.

Conclusion: Ligation and clipping of the appendiceal base are both practical and safe, exhibiting similar complication rates. However, ligation requires more training and results in longer operative times, while clipping is simpler and easier for trainers.