Transcolonic Endoscopic Appendectomy: A Single-Step "Two-In-One" Approach for Recurrent Appendicitis With Appendiceal...

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Procedures

Background:

• Appendiceal orifice lesions can occur in patients with recurrent appendicitis.
• Conventional surgery may involve unnecessary trauma.
• Transcolonic endoscopic appendectomy (TEA) is a proposed minimally invasive alternative.

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of TEA.
• To compare the effectiveness of two closure methods: through-the-scope twin clips (TTS-TC) plus metal clips versus metal clips alone.

Main Methods:

• Twenty patients with recurrent appendicitis and no prior abdominal surgery underwent TEA.
• Clinical, pathological, and procedural variables were analyzed.
• Outcomes were compared between TTS-TC plus metal clips and metal clips alone for defect closure.

Main Results:

• All TEA procedures were technically and clinically successful.
• The TTS-TC plus metal clips group showed reduced suture time, procedure time, and number of clips used compared to metal clips alone.
• No adverse events were reported, and follow-up colonoscopy revealed no residual lesions or recurrence.

Conclusions:

• TEA is a feasible, safe, and effective treatment for recurrent appendicitis with appendiceal orifice lesions.
• TEA offers a minimally invasive dual-benefit approach.
• A novel closure method using TTS-TC combined with metal clips can streamline the procedure.