Assessment of Low Cost Laparascopic Appendectomy A Comperative Study between Intracorporeal Ligation and Clipping to Secure Appendicular Stump

Abstract Background The first laparoscopic appendectomy was done in the 1970s by gynecologists. The standard operation of acute appendicitis is laparoscopic appendectomy where minimal invasive surgery is performed. Objective To compare between clipping and intra-corporeal ligation of appendicular stump regarding safety, timing of operation, difficulty, any post operative complication and cost. Patients and Methods This was a prospective randomized clinical study will be conducted in Ain Shams University hospitals that was conducted on 100 cases of acute appendicitis that were subjected to laparoscopic appendectomy. They were divided into two groups. Group 1 (50 patients) ligation group. Group 2 (50 patients): clip group. Results Our study revealed that, median operative time for intracorporeal ligation group is 55.6 minutes. Median operative time for titanium clips group is 46.44 minutes with highly statistically significant difference. The present study showed that, there was no statistically significant difference between the two group regarding post-operative hospital stay and return to work. In this study, there is no big difference in the total post-operative complications between clipping and intra- corporeal ligation groups. Conclusion Both methods of intracorporeal ligation and clip application are cost effective in securing the appendicular stump. metal clip application is more easy to the surgeon, more time saving during the operation and less post-operative stay in the hospital. The only limitation of the clip application is the wider diameter of the base of the appendix beyond the large titanium clip in these cases intra-corporeal ligation is a safe and cheap alternative.