# Using the endoscopic snare to facilitate two-port laparoscopic appendectomy

## TL;DR

This study introduces a new two-port laparoscopic appendectomy technique using an endoscopic snare, showing it is safe and improves patient recovery and satisfaction.

## Contribution

A novel technique using an endoscopic snare to perform two-port laparoscopic appendectomy is introduced and validated.

## Key findings

- All 85 procedures were completed without difficulty, with a mean operative time of 43.78 minutes.
- The average hospital stay was 1.12 days, and four minor complications occurred but resolved within a week.
- Patients reported high satisfaction and excellent cosmetic outcomes with the two-port technique.

## Abstract

Laparoscopic appendectomy is now the gold-standard treatment for acute appendicitis, requiring three ports for a classic procedure. Recent laparoscopy improvements aim to minimize surgical trauma and improve cosmetic quality through smaller, fewer portal incisions, such as two-port laparoscopic appendectomy, resulting in reduced postoperative pain. We aimed in this study to describe a novel technique to facilitate two-port laparoscopic appendectomy using the endoscopic snare.

The data for a total of 85 patients, who underwent the two-port laparoscopic appendectomy using the endoscopic snare, at two research centers in Zagazig city, Egypt, from July 2022 till July 2023, is retrospectively analyzed. Overall length of hospital stay was the primary outcome, and the duration of operation and patient cosmetic satisfaction were secondary endpoints.

All the 85 laparoscopic procedures were completed without difficulty. The mean operative time was 43.78 ± 8.46 min (minimum: 34 min, maximum: 57 min). Length of hospitalization was 1.12 ± 0.74 days (min: 1 day, max: 2 days). No major complications were encountered. Four cases of minor postoperative complication occurred, in which the patient developed port site infection, which was completely resolved at one week postoperatively.

Laparoscopic appendectomy, using only two ports and endoscopic snare, is generally feasible and has been linked to high patient satisfaction and excellent cosmetic outcomes.