Subserosal appendicular stripping

Appendicectomy in patients with recurrent appendicitis can be difficult due to an adherent and inflamed appendix. We describe the technique and results of subserosal appendicular stripping (SAA). Over a four-year period, 49 patients who were diagnosed with recurrent appendicitis required SAA. They had prior admission for acute appendicitis which resolved with antibiotic treatment. Persistent symptoms necessitated surgery. SAA was necessary in these patients due to an inflamed, adherent appendix with extensive serosal adhesions. The appendix was delivered out from the serosa following retrograde ligation of the appendicular base. The adherent serosa was left intact. Average patient age was 23 years. All had persistent symptoms for more than one week with a history of one or more previous attacks. No surgical complications were observed except transient serosal bleeding in the first case managed by gentle diathermy. We advocate SAA as a modification of appendicectomy in patients with recurrent appendicitis where the appendix is inflamed and adherent.