Sutureless Laparoscopic Appendectomy: Bipolar Maryland Versus Endoloop Technique. A Randomized Controlled Trial

Sutureless laparoscopic appendectomy is performed using energy devices for dissection of the mesoappendix as well as sealing the base of the appendix without any use of clips, ligature, or knots. The study attempted to explore the feasibility and safety of a conventional bipolar Maryland forceps in completing laparoscopic sutureless appendectomy without using any other advanced energy device.

It was a randomized controlled trial conducted on 180 patients. It included patients with uncomplicated acute appendicitis. The patients were randomly divided into two groups and underwent laparoscopic appendectomy using endoloop or conventional bipolar electrosurgery using Maryland forceps.

The mean age group of the study population was 26.21 ± 7.98 years. Mean operating time in the endoloop group was 29.36 and 23.10 min in the bipolar Maryland group (p = 0.339). The mean diameter of the excised appendix specimen was 7.27 ± 0.95 mm in the former group, whereas 7.48 ± 0.96 mm in the latter group (p = 0.266). There were no significant postoperative complications in either group.

It appears that sealing the appendicular base using conventional bipolar electrosurgery (Maryland) is safe and feasible without any significant complications and can be used conveniently in sutureless laparoscopic appendectomy.

CTRI number: 069386; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=OTMyNTU=&Enc=&userName=.