scholarly journals Laparoscopic Appendectomy with Immersive Appendiceal Stump Closure in Patient with Vermiform Appendix Abnormality

2020 ◽  
Vol 10 (2) ◽  
pp. 149-153
Author(s):  
S. P. Muzhikov ◽  
M. Yu. Eremenko ◽  
V. V. Shefer ◽  
E. E. Selezneva
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Clinical Case ◽  
Vermiform Appendix ◽  
Treatment Alternative ◽  
Stump Closure ◽  
Appendiceal Stump ◽  
Laboratory Examinations ◽  
Appendiceal Stump Closure ◽  
Emergent Surgery

Background. Acute appendicitis is a common emergency surgical pathology, with laparoscopic appendectomy being the “gold standard” in its treatment.Aim. We report a clinical case of laparoscopic appendectomy with immersive appendiceal stump closure in a patient with vermiform appendix abnormality.Materials and methods. Patient K. was emergently admitted to the Surgical Hospital of Ekaterininskaya Clinic in June 2019 with a clinical picture of acute appendicitis. Symptoms, disease anamnesis, instrumental and laboratory examinations conformed to acute appendicitis.Results and discussion. The patient was rendered an emergent surgery. Intraoperative picture corresponded to acute phlegmonous appendicitis with malformation (a wide conical base) of the vermiform appendix. Immersive appendiceal stump closure was chosen as treatment. Alternative opinions coexist on justifying a particular appendiceal stump closure strategy. Immersive treatment is our method of choice in terms of implementation and safety in the particular clinical case. Th is method requires the surgeon’s technical experience.Conclusion. A clinical case is reported of performing laparoscopic appendectomy with immersive appendiceal stump closure in a patient with vermiform appendix malformation. Despite the appendix abnormality, immersive treatment of the appendiceal stump was justified as safe in this case and entailed no complications in postoperative period.

Technical modifications of appendiceal transection during laparoscopic appendectomy

2020 ◽  
Vol 99 (12) ◽  
Keyword(s):  
Postoperative Complications ◽  
Laparoscopic Appendectomy ◽  
Postoperative Morbidity ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Stump Closure ◽  
Technical Modifications ◽  
Appendiceal Stump ◽  
Appendiceal Stump Closure

Introduction: Appendiceal transection is the most critical part of laparoscopic appendectomy (LAPPE). The aim of our study was to evaluate postoperative and economic outcomes of laparoscopic appendectomy with different technical modifications of transection of the appendix. Methods: This was a prospective, randomized, unicenter clinical study comparing different techniques of appendiceal transection in patients with acute appendicitis during the study period (18 months). The patients were randomized to one of three arms – endoloop, hem-o-lok clips and the stapler. Results: In total, 120 patients were enrolled in the study. The shortest operative time was noted in the hem-o-lok arm (37.3 minutes); mean length of hospital stay (3.7 days) was comparable in all study arms. Postoperative morbidity was 6.6%; all recorded complications were SSIs (Surgical Site Infections). The number of postoperative complications was comparable in all study arms. Mean direct costs of laparoscopic appendectomy were lowest in the hem-o-lok arm. According to our findings, LAPPE is not a profit making surgery irrespective of the type of appendiceal transection (mean profit in the study patients was CZK -4019). Conclusion: The rate of postoperative complications was similar for all the technical modifications of appendiceal stump closure. As indicated by the study outcomes, hem-o-lok clips have the potential of becoming the method of choice in securing the appendix base during LAPPE.

Cost Effectiveness of Different Methods of Appendiceal Stump Closure during Laparoscopic Appendectomy

2018 ◽  
Vol 84 (8) ◽  
pp. 1329-1332 ◽  
Author(s):  
Samuel Kim ◽  
Leonard Weireter
Keyword(s):  
Laparoscopic Appendectomy ◽  
Care Center ◽  
Tertiary Care ◽  
Complication Rates ◽  
Price Difference ◽  
Procedure Time ◽  
Stump Closure ◽  
Appendiceal Stump ◽  
Appendiceal Stump Closure ◽  
Room Time

There is no standard method for closure of an appendiceal stump during laparoscopic appendectomy. This study compares stump closure using a stapler with closure using an Endoloop ligature. The charts of all patients who underwent laparoscopic appendectomy at a single tertiary care center over a two-year period were reviewed for demographics, comobidities, operative details and costs, and outcomes. There were 325 patients who underwent a laparoscopic appendectomy. The majority, 250 (77%), underwent stump closure with a stapler. They were equivalent in demographics and postoperative complication rates. Cases using an Endoloop were slightly faster in terms of procedure time and room time, and less expensive in terms of operative supply cost. The price difference is not explained by time saved in the operating room and more likely by the equipment price.

scholarly journals Appendiceal stump closure by metal endoclip in the management of complicated acute appendicitis

2013 ◽  
Vol 8 (1) ◽  
Author(s):  
Carlos Augusto Gomes ◽  
Cleber Soares Junior ◽  
Rodrigo Oliveira de Peixoto ◽  
Jose Murillo Bastos Netto ◽  
Camila Couto Gomes ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Stump Closure ◽  
Appendiceal Stump ◽  
Appendiceal Stump Closure ◽  
Complicated Acute Appendicitis

scholarly journals Acute Appendicitis Secondary to Appendiceal Endometriosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
João Paulo Nunes Drumond ◽  
André Luis Alves de Melo ◽  
Demétrius Eduardo Germini ◽  
Alexander Charles Morrell
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Clinical Picture ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Vermiform Appendix ◽  
Histopathological Analysis ◽  
Women Of Childbearing Age ◽  
Childbearing Age

Endometriosis in the vermiform appendix is a rare condition that affects women of childbearing age. The clinical picture can simulate inflammatory acute abdominal pain, especially acute appendicitis. Laboratory and imaging tests may assist in the diagnosis but are not conclusive. This article reports a case of acute appendicitis caused by appendiceal endometriosis for which laparoscopic appendectomy and diagnostic confirmation were performed after histopathological analysis.

Analysis of staplingversus endoloops in appendiceal stump closure

2006 ◽  
Vol 93 (11) ◽  
pp. 1390-1393 ◽  
Author(s):  
G. Beldi ◽  
S. A. Vorburger ◽  
L. E. Bruegger ◽  
T. Kocher ◽  
D. Inderbitzin ◽  
...  
Keyword(s):  
Stump Closure ◽  
Appendiceal Stump ◽  
Appendiceal Stump Closure

scholarly journals LAPAROSCOPIC APPENDECTOMY;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Muhammad Umar Younis ◽  
Muhammad Zeeshan Sarwar ◽  
Sanad Saad
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Local Population ◽  
Sampling Technique ◽  
Short Operative Time ◽  
Cross Sectional ◽  
Stump Closure ◽  
Study Results ◽  
The Mean

Introduction: Appendicitis is a condition characterized by inflammation of the appendix and is considered to be the most common emergency encountered in surgical practice. Compared with the open technique for appendectomy, laparoscopic appendectomy has less operative time, hospital stay and rate of complications and has been deemed as a safe and feasible procedure for the treatment of acute appendicitis. The use of endoclips for stump closure has been described to be comparable to other existing techniques with regards to clinical outcomes. However, controversies exist in literature regarding operative time with endoclip application. Objectives: To assess mean operative time for laparoscopic appendectomy using specially designed Double Shanked (DS) endoclips and assessing advantages in the form of better cosmesis, less pain. Study Design: Cross sectional exploratory study using non-probability sampling technique. Setting: West Surgical Ward of Mayo Hospital Lahore. Period: Period of 9 months from April 2014 through to December 2014. Materials and Methods: 120 successive patients fulfilling inclusion criteria were enrolled in the study. Clinical data with respect to their demographic profile (age and sex) were recorded. Laparoscopic Appendectomy was performed or supervised by one consultant. Quantitative variables such as age and operative time was analyzed and mean and standard deviation were calculated. Results: Our study results showed the mean age of the patients to be 25.84±8.09 years. There were 63.3% males whereas 36.7% were females. The mean operative time of the patients was noted to be 0.99±0.39 hours. Conclusions: The study results lend credence to the fact that Laparoscopic Appendectomy with endoclips is a safe, effective technique and has an admissible short operative time which when combined with better cosmesis, lesser pain and faster recovery, give it validity and acceptability. Our results generated for the local population will influence our management strategy for acute appendicitis in our set up.

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