Our Summary

This research paper looked at three different ways to close off the appendix during laparoscopic (keyhole) appendectomy (removal of the appendix). They looked at patient data from January 2018 to June 2020, involving 733 patients.

The appendix was closed off in one of three ways: using a single loop (1EL group), using two loops (2EL group), or using two clips (2EC group). All the methods used a tool called LigaSure to cut off the appendix.

They found that only a few patients developed an abscess (a pocket of pus) after surgery: 1% in the 1EL group, 1% in the 2EL group, and none in the 2EC group. There were no cases where the appendix leaked.

The overall rate of complications was also low: 4% in the 1EL group, 3% in the 2EL group, and none in the 2EC group. The average time for the operation was 43 minutes for the 1EL group, 54 minutes for the 2EL group, and 43 minutes for the 2EC group.

The cost of the loops and clips was also considered: one loop cost $110, and one clip cost $180.

The researchers concluded that all three methods were equally effective and safe. Given the low rate of complications and the cost difference, it makes sense to use the single loop method, which could significantly reduce costs. They suggest that hospitals could recommend this method to their surgeons.

FAQs

  1. What were the three methods used to close off the appendix during the laparoscopic appendectomy in this research?
  2. What were the percentages of patients who developed complications after the surgery, according to the method used?
  3. What were the average costs of the loops and clips used in the appendectomy, and what method did the researchers suggest as the most cost-effective?

Doctor’s Tip

One helpful tip a doctor might tell a patient about appendectomy is to follow their post-operative care instructions carefully. This may include taking prescribed pain medication, resting, avoiding strenuous activities, and monitoring for any signs of infection or complications. It is important to attend follow-up appointments with your healthcare provider to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for an appendectomy include those who are experiencing symptoms of appendicitis, such as abdominal pain, nausea, vomiting, and fever. In some cases, imaging tests may be used to confirm the diagnosis before surgery is recommended. Additionally, patients who have a history of recurrent appendicitis or complications related to appendicitis may also be recommended for an appendectomy.

Timeline

Before appendectomy:

  1. Patient experiences symptoms of appendicitis, such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes diagnostic tests, such as physical examination, blood tests, and imaging studies (ultrasound or CT scan) to confirm appendicitis.
  3. Patient is scheduled for laparoscopic appendectomy surgery.

After appendectomy:

  1. Patient undergoes laparoscopic appendectomy surgery, where the appendix is removed using one of the three closure methods: single loop, two loops, or two clips.
  2. Patient stays in the hospital for a few days for monitoring and recovery.
  3. Patient may experience some pain and discomfort post-surgery, which can be managed with pain medication.
  4. Patient is discharged from the hospital once they are stable and able to resume normal activities.
  5. Patient follows up with their surgeon for any post-operative care or concerns.
  6. Patient typically recovers fully within a few weeks and can resume normal activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about appendectomy based on this research paper include:

  1. What method of closing off the appendix do you plan to use during my laparoscopic appendectomy?
  2. What are the potential risks and complications associated with each method of closure?
  3. Have you had experience using the single loop method, and do you feel confident in its effectiveness?
  4. How does the cost of the closure method factor into the overall cost of the surgery, and will it affect my out-of-pocket expenses?
  5. Based on this research, do you recommend the single loop method for my appendectomy, or do you suggest a different method based on my individual case?
  6. What is the expected recovery time and post-operative care for each closure method?
  7. Are there any specific factors in my case that may make one closure method more appropriate than another?
  8. How often do you perform laparoscopic appendectomies, and what is your success rate with each closure method?
  9. Are there any additional considerations or information I should be aware of regarding the closure method for my appendectomy?
  10. Can you provide me with more details or resources on the research supporting the use of the single loop method for appendectomies?

Reference

Authors: Yaron R, Hagai S, Nayyera T, Nili G, Shai KD, Shmuel A. Journal: Langenbecks Arch Surg. 2023 Jul 10;408(1):270. doi: 10.1007/s00423-023-03012-1. PMID: 37428286