Abstract

Aim: During laparoscopic appendectomy, to secure appendiceal stump, endoscopic clip, endoloop, intra-extra corporal knottings are used. This experimental study aims to compare the reliabilities of nonabsobable polymer clips and suture ligation which are used for appendiceal stump during laparoscopic appendectomy by measuring caecal bursting pressure.

Material and Method: In this study, 24 Wistar Albino rats were randomized into two groups; as perforated (P) and nonperforated (NP) Groups. These two groups were further divided polymer clip (PC) and suture ligation (SL) subgroups. In the NP group, polymer clips, and suture ligations were used in 6 rats, respectively. and then caecal bursting pressure was measured In Group P, the same procedure was done by re-laparotomy 24 hours after perforation.

Body weights of the rats diameters of appendices, operative times and caecal bursting pressures were measured.

Results: Intragroup comparisons in Groups NP and P did not demonstrate any statistically significant difference in body weights, diameters of appendices, and caecal bursting pressures among rats. However, operative times were significantly shorter in Group PC. In group PC, all rats survived after the first operation without any postoperative problem.

Conclusion: In this study, no leakage from appendix stump was observed despite high pressures applied which resulted in serosal peeling and caecal perforation in both groups. This experimental study supports the reliability of widely used suture ligation method and shows that polymer clips application method is as reliable and effective as suture ligation in shortening operative times