Study of Various Techniques of Appendicular Stump Closure during Laparoscopic Appendectomy

Introduction Stump ligation & burial which was a standard technique in open appendectomy was replaced by knotting of stump in laparoscopic appendectomy. Various techniques of stump management includes Roeders knot, Endoloop, Knotting at proximal (caecal end) & Bipolar coagulation distally, Bipolar coagulation only, Titanium clips, Endostapplers etc. Our Study is conducted in PDVVPFs Medical College, Ahmednagar where 40 diagnosed patients of appendicitis were subjected to laparoscopic appendectomy in last 6 months & divided in 4 groups. Material and Method In our series stump was managed by using 1) Endo-loop 2) Intracorporeal knotting 3) Knotting at proximal (caecal end) & Bipolar coagulation distally 4) Bipolar coagulation only. These Four groups were followed for period of 3 months. Inclusion criteria 1 Patients of acute/recurrent appendicitis after valid informed consent. Exclusion criteria1) Patients who are unfit for laparoscopic procedure 2) Patients with appendicular lump. Results Results were compared on following parameters 1 Operative time 2 Complications 3 Hospital Stay 4 Cost. The result of different groups are compared & it is observed that a feared technique of bipolar coagulation of stump in laparoscopic appendectomy is found to be safe effective, easily performed & reduces cost. Conclusion Bipolar coagulation when compared with other techniques was found to be highly economical & effective in saving operative time without compromising any safety.