Outcome of Laparoscopic Appendectomy with Clipping versus Harmonic Scalpel for Closure of the Appendicular Stump: A Comparative Clinical Study | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 108, Volume 98, Issue 1, January 2025, Page 755-758 PDF (543.7 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.411579 | ||||
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| Abstract | ||||
| Background: Many approaches were used to close the appendicular stump; some are costly as endoscopic linear cutting staplers; others are not present in some hospitals for example loop knots (endo-loops). Aim: the current study aimed to compare clipping versus harmonic scalpel of the appendicular stump regarding the safety of the techniques, operative time, and outcomes. Patients and Methods: 146 patients presented with acute appendicitis (AA) at the Emergency Department were divided randomly into two groups: Group A: where a harmonic scalpel (HS) was used to close the appendicular stump and Group B: where a metal clip (MC) was used. Follow-up was designed for at least 1 month for early postoperative complications Results: Concerning postoperative sequelae, we reported a significant decrease in operative time in the HS group (p-value of 0.012*), regarding the hospital stay no significant difference was found between the two groups. The complications were lower in the HS group. In the MC group, two patients developed localized abdominal collection and required readmission. Those patients were managed conservatively by ultrasound-guided percutaneous drainage of the collection and did not require reoperation. Conclusion: Clipping and harmonic scalpel are effective in securing the appendicular stump. We prefer harmonic scalpel over clipping especially with a wide, and fragile appendiceal stump. | ||||
| Keywords | ||||
| AA; Appendiceal stump; Clipping; Harmonic Scalpel | ||||
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