[Laparoscopic appendectomy with endoloop: results of our experience]

There are several different techniques for laparoscopic appendectomy (LA), with different material requirements and approach. We present the results from our series, where we employ monopolar hook for mesoappendix dissection and double polyglactin endoloop for ligation of appendicular stump. The appendix is taken out through the Hasson trocar without any contact with abdominal wall, in a completely laparoscopic procedure. We sought to analyze the security of this technique. We reviewed retrospectively every LA for acute appendicitis performed during the last 10 years in our Hospital. We collected data regarding surgical procedure and postoperative outcome, focusing on intraoperative or postoperative complications. A total of hundred and ten (110) LA for acute appendicitis (from simple appendicitis to perforated appendicitis) were performed. Mean operative time was 74.7 minutes (median 70 min, SD 24.43 min, min. 25, max. 130 min). Ten patients (9.09%) had postoperative complications, consisting in intraabdominal abscess in 6 patients (5.4%) and wound infection in 3 patients (2.7%). No major complication was found, as uncontrolled hemorrhage, bowel perforation or stump dehiscence. No patient needed a second surgical procedure in the postoperative time. Laparoscopic appendectomy with polyglactin endoloops is a completely laparoscopic and safe procedure, without any intraoperative complication in our series. Laparoscopic approach with 12 mm Hasson trocar and two 5 mm working trocars allows a nice aesthetic result.