Clinical Outcome of Retrograde Laparoscopic Appendicectomy Using Single Hem-O-Lock Clip for Complicated Versus Non-Complicated Appendicitis

Laparoscopic appendicectomy is safe and feasible for non-complicated appendicitis. The use of retrograde appendicectomy allows feasibility also for complicated cases. Using single polymer clip for securing appendicular stump is safe as well as two clips.
To evaluate the clinical outcome of using single Hem-O-Lock polymer clip and to compare technical feasibility of retrograde laparoscopic appendicectomy for complicated versus non-complicated appendicitis in adults.
Patients and A single institute prospective study was done between August 2012 and April 2014. From 78 patients presenting with acute appendicitis to emergency unit, Zagazig University hospitals, only 60 patients were eligible. Three retrograde laparoscopic appendicectomy ports were used in both groups (group I, complicated appendicitis and group II, non-complicated appendicitis) and a single Hem-O-Lock polymer clip was applied to secure the appendicular stump. Standardized data collection was performed and data collected by the attending resident and attending physician. The primary clinical outcome was the severity of pain at 1 - 7 days. Secondary outcomes included the duration of operation (minutes), procedure-related complications, conversion rates, and length of hospital stay.
Four patients (15.4%) were converted to open surgery; three patients in group I and one in group II. Four patients developed postoperative complications; three patients in group I and one in group II. Operative time was less in group II and was statistically different and the P value was significant 0.05.
Retrograde laparoscopic appendicectomy using single polymer clip makes easy access to operating in complicated and non-complicated appendicitis.