A One Year Randomised Control Trial To Compare Appendiceal Stump Closure Technique With Liga- Clips V/S Hem-O-Lok In Laparoscopic Appendectomy In Kle’s Dr Prabhakar Kore Hospital, Belagavi

Abstract

INTRODUCTION: Although surgical technique for LA has been well established, concerns and controversy exists regarding CAS, which is a crucial step in the procedure. It is considered so because most grievous complications following LA occur due to leak of the stump. The risk of developing life-threatening complications like enterocutaneous fistulas, postoperative peritonitis, sepsis is dreaded and undesired. An ideal technique for appendiceal stump closure is considered the one that is safe, more feasible, simpler to use, and relatively economical. Recent studies have established the use of endoclips simpler and quicker as special laparoscopic skills are not required and hence seamlessly adapted. METHODS: A total of 60 patients diagnosed with appendicitis without complications planned for LA were enrolled for the study. They were divided into two groups, A & B, of 30 each. Liga Clips were used for CAS in group A and Hem-o-Lok in group B and operative time, intra-op and post op events were recorded. RESULTS: The mean operative time (time from skeletonisation of appendix to retrieval of the appendix) in group A was noted to be 376.03 seconds (~6.27 minutes) and that in group B was noted to be 345.50 seconds (~5.75 minutes)(p~0.2873). None of the patients enrolled in the study developed stump leak or intra- abdominal abscess and none of them had to undergo reoperation. CONCLUSION: In conclusion, the use of both endoclips like Liga Clips and Hem-o-Lok for CAS in LA is quicker, safe, secure and feasible technique in cases of appendicitis (Acute or Chronic) without increased risk of complications. In our experience, it is suggested that Hem-o-Lok is more efficient in securing the appendiceal stump due to it’s lock engagement system giving a sense of security and ease of application.