Non Absorbable Clips vs Endoloops in Laproscopic Appendicectomy

Study Overview
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Brief Summary
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a) Compare between Nonabsorbable Polymeric Clips and Endoloop ligatures regarding: technical difficulties. operation time. cost effectiveness. postoperative complications. inpatient stay.

Detailed Description
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Laparoscopic appendectomy is gradually evolving as the 'gold standard' in the treatment of acute appendicitis, especially in the obese, elderly, and in cases where the diagnosis is uncertain . There are clear benefits with the laparoscopic approach in terms of decreased pain and faster recovery than the open approach . However, disadvantages like a higher incidence of intra-abdominal collection, longer operating time, and higher costs have been documented. These may be dependent on the technique of appendicular stump closure. Therefore, the technique for appendiceal stump closure is crucial in laparoscopic appendectomy. Laparoscopic appendectomy was first described by Semm in 1983 and is currently preferred approach for an appendectomy for many surgeons. Numerous methods of stump closure have been used, like intracorporeal suturing of the stump endoloop application, endostapler application LigaSure customized titanium clip application, and, more recently, using nonabsorbable plastic clips . Many of these techniques are either time consuming or expensive, or not available universally.

Official Title
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A Comparison Between Non Absorbable Polymeric Clips and Endoloop Ligatures in Securing Appendicular Stump in Laparoscopic Appendicectomy at Assiut University Hospital

Conditions
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Appendicitis

Intervention / Treatment
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* Device: polymeric non absorbable clips
* Other: endoloops


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: . Able to give informed consent for inclusion in the study Age of the patient : Any age Exclusion Criteria: • Intraoperative decision to convert to open appendicectomy Primary open appendicectomy Unable to give informed consent for participation in the study
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: endoloop ligation<br>securing appendicular base with endoloops | Other: endoloops<br>* a method to secure appendicular stump<br>|
| Active Comparator: non absorbable polymeric clips<br>securing appendicular base with non absorbable polymeric clips | Device: polymeric non absorbable clips<br>* a method to secure appendicular stump<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Operative time | Is there difference in the overall operating time between the two cohorts | intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complications | Is there a difference in the rate of intraoperative and postoperative complications | 30 days | 
| Length of hospital stay (postoperative) | Is there a significant difference in the length of postoperative stay between the two cohorts | Up to 14 days | 
| Readmission to hospital | Is there a difference in the thirty day readmission rates between the two cohorts | 30 days | 
| Time of Application | Time of application of endoloop, polymeric clip measured from introducing of instruments to cutting the base of appendix | 120 min |