# Comparison of Polymer Clips Versus Endoloop Ligatures for Appendiceal Stump Closure in Laparoscopic Appendectomy

## TL;DR

This study compares two methods for closing the appendix during surgery and finds that polymer clips lead to faster recovery and less pain.

## Contribution

The study provides empirical evidence that polymer clips outperform endoloop ligatures in laparoscopic appendectomy outcomes.

## Key findings

- Polymer clips reduced hospital stay by nearly a day compared to endoloop ligatures.
- Polymer clips resulted in shorter operative times and lower postoperative pain scores.
- Polymer clips were associated with fewer surgical site infections and abdominal pain cases.

## Abstract

Objective: This study aimed to compare the safety and effectiveness of endoloop ligatures (ELs) (Ethicon India Pvt. Ltd., Mumbai, India) and polymer clips (PCs) (Medtronic India Pvt. Ltd., Hyderabad, India) for appendiceal stump closure during emergency laparoscopic appendectomy.

Methods: A prospective clinical study was conducted at Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, India, including 70 patients who underwent laparoscopic appendectomy. Patients were randomly assigned to either the PC or EL group. Data collected included operative time, postoperative pain (measured using the visual analog scale), length of hospital stay, and postoperative complications.

Results: Baseline characteristics were comparable between the two groups. The PC group had a significantly shorter hospital stay (3.63 ± 0.77 vs. 4.20 ± 0.93 days; p = 0.007) and shorter operative time (61.46 ± 10.76 vs. 68.03 ± 8.80 minutes; p = 0.006) compared to the EL group. Postoperative pain scores were also significantly lower in the PC group at one, three, six, and 12 hours after surgery (p = 0.001). Although the overall incidence of complications did not differ significantly, abdominal pain and surgical site infections were less frequent in the PC group.

Conclusion: PCs are a safe and effective alternative to endoloops for appendiceal stump closure in laparoscopic appendectomy. They offer the advantages of reduced operative time, shorter hospital stays, and lower postoperative pain.