Comparative Analysis of Laparoscopic Appendiceal Stump Closure Techniques in South Punjab, Pakistan

Abstract Background: The study aimed to compare the efficacy of metallic endo-clips and extracorporeal knotting techniques for closing the appendiceal stump in laparoscopic appendectomy. The primary objectives were to assess the impact on surgery duration, hospital stay, and postoperative complications, focusing on identifying the potential benefits of using metallic endo-clips. Materials and Methods: A retrospective comparative study was conducted at Nishtar Medical University, Multan. Patients were divided into two groups: Group A received metallic endo-clips, while Group B underwent extracorporeal knotting. Data were collected from surgical notes and discharge forms, and statistical analysis was performed using SPSS version 25. Results: Among the 70 patients, 62.9% were male, and 37.1% were female. The male-to-female ratio was 2:1. Most patients (81.4%) were aged up to 35 years, with 68.6% from urban areas. Using metallic endo-clips, Group A had a significantly shorter mean surgery duration (28.89 minutes) than Group B (34.23 minutes). Hospital stay duration showed no significant difference between the two groups. Only 4.3% of patients experienced complications, with a slightly higher incidence in Group B (66.7%). Conclusions: The study suggests that using metallic endo-clips for laparoscopic appendiceal stump closure offers potential benefits, including shorter surgery duration and lower rates of complications. This technique may enhance surgical efficiency and reduce the risk of prolonged anesthesia and surgery. Although this study had some limitations, it highlights the promise of metallic endo-clips as a viable alternative for appendiceal stump closure in laparoscopic appendectomy.