Comparative Effectiveness of Endoloop, Instrumental Tie and Ligaclip in Laparoscopy Appendectomy

Abstract

Background: Appendectomy is the most commonly performed surgical procedure for patients. To examine the safety, complications, and cost-effectiveness of the instrumental tie, ligaclip and endoloop procedures have been used for the closure of the appendix stump. The objective of this study was to analyze the clinical outcomes, as well as to compare the effectiveness of the endoloop, instrumental tie, and ligaclip in laparoscopic appendectomy procedures.

Methods: The Sir Syed Medical College Hospital, Karachi was the center of this Randomized Control Study, from June 2020 to December 2020. Acute appendicitis patients (n=120) having age 7-85 years were categorized into three groups: A, B, and C. Ligaclips were applied to those in Group A, Instrumental Tie to Group B, and Endolope to Group C patients. Each group consisted of 40 participants. The Kolmogorov Smirnov test was used to determine the variables for normal distribution. The Chi-square test was used to measure the association between the duration of surgery and hospital stay.

Results: The statistical significance (p<0.05) of the relationship between the length of hospital stay and the duration of surgery had been established. The ligaclip demonstrates the shortest hospital stay of 2-3 days and the shortest operation time of 50-60 minutes, whereas the instrumental tie displayed the longest operation time of 72-75 minutes and the longest hospital stay of 4-5 days.

Conclusion: Ligaclip application of the appendiceal base showed statistically significant outcomes (p=0.00) regarding technical comfort, cost-effectiveness and operating time compared to endoloop and surgical tie applications.

Keywords: Ligaclip; Instrumental Tie; Endoloop; Laparoscopy Appendectomy.