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Laparoscopic appendectomy using endoloops: a prospective, randomized clinical trial.

G Beldi¹, K Muggli, C Helbling

¹Department of Surgery, Kantonsspital Aarau, CH-5001, Aarau, Switzerland.

Surgical Endoscopy

|March 18, 2004

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For laparoscopic appendectomy, using a single endoloop to close the appendix stump is as safe as using two. This approach reduces complications in patients with acute appendicitis.

Area of Science:

Surgical innovation
Minimally invasive surgery
Gastrointestinal surgery

Background:

Inadequate closure of the appendix stump can cause serious complications like abscess formation or peritonitis.
Laparoscopic appendectomy is a common surgical procedure for appendicitis.

Purpose of the Study:

To evaluate the efficacy and safety of using a single endoloop versus two endoloops for appendix stump closure during laparoscopic appendectomy.
To compare intra- and postoperative complication rates between the two groups.

Main Methods:

A prospective randomized clinical trial involving 208 patients undergoing laparoscopic appendectomy.
Patients were divided into two groups: Group 1 (109 patients) used one proximal endoloop, and Group 2 (99 patients) used two proximal endoloops.

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Comparison of intraoperative and postoperative complications between the groups.

Main Results:

Five patients (4.6%) in Group 1 experienced postoperative complications, including intraabdominal abscesses, pulmonary embolism, and port-site pain.
Five patients (5.1%) in Group 2 experienced postoperative complications, including intraabdominal abscesses and prolonged percutaneous drainage.
No significant difference in complication rates was observed between the one-endoloop and two-endoloop groups.

Conclusions:

A single endoloop is sufficient for safely dividing the appendix stump in cases of acute appendicitis with a minimally inflamed base.
This finding supports the use of fewer endoloops, potentially simplifying the procedure and reducing costs.