Page 7 - World Journal of Laparoscopic Surgery

WJOLS
WJOLS

10.5005/jp-journals-10033-1228
Clinical Experiences of Trans-Trocar Appendix Removal in Laparoscopic Appendectomy
OriginaL articLe

Clinical Experiences of Trans-Trocar Appendix Removal in

Laparoscopic Appendectomy

Jung Min Bae

ABSTRACT appendicitis was treated in open surgery. But, after lapa­
1
Purpose: Most of laparoscopic instruments are disposable and roscopic appendectomy was performed firstly in 1983,
not reusable. Therefore, laparoscopic surgery is more ineffec- laparoscopic appendectomy is most popular method in
tive according to environment conservation and recycling of treatment of acute appendicitis.
resources than open surgery.
Trans-trocar appendix removal method was shown instead There are many laparoscopic surgical instruments in
of using disposable specimen vinyl bag. Advantages of trans- laparoscopic appendectomy. Most of all in laparoscopic
trocar removal are cost-effective and decrement of disposable instruments are disposable and not reusable. Therefore,
instrument. But, there has not been cited in the literature about
clinical experiences and outcomes.Therefore, this study was laparoscopic surgery is more ineffective surgery accor­
conducted to analyze the clinical outcomes. ding to environment conservation and recycling of
Materials and methods : Uncomplicated appendicitis patients resources than open surgery. So, many method and reus­
were reviewed retrospectively in 2013. The enrolled patients able laparoscopic instruments are developed to improve
were divided as trans-trocar appendix removal group (TTAR) environment conservation and recycling of resources. 2,3
and disposable specimen vinyl bag group (DSVB). Clinical data
and outcomes were analyzed and compared. Among this effort, when resected appendix in laparo­
Results: A total of 119 patients undergoing laparoscopic appen- scopic appendectomy was removed, trans­trocar removal
dectomy were enrolled. Fifty-nine patients belonged to TTAR method was shown instead of using disposable specimen
and 60 patients were DSVB. In the both groups, there were vinyl bag.
4-9
no significant differences in postoperative outcomes. Success
rate of trans-trocar removal was 89.3%. According to body Advantages of trans­trocar appendix removal method
2
mass index (BMI), success rate is 100% below 20 kg/m , are cost­effective and decrement of disposable instrument
2
2
87.8% in patients between 20 kg/m and 25 kg/m and 61% because specimen vinyl bag is not needed in appendix
2
above 25 kg/m . removal.
Conclusion: Although, it is difficult to generalize the results, But, although trans­trocar appendix removal method
it is thought that trans-trocar appendix removal is alternative
2
and feasible on basis of our study. But in BMI > 25 kg/m , it is was introduced 10 years ago, there has not been cited in
thought to be technically careful to perform trans-trocar appen - the literature about clinical experiences and outcomes.
dix removal. It is also necessary to make comparison the Therefore, this study was conducted to compare the
efficacy of appendix removal methods through prospective
randomized clinical study to establish the better method for clinical outcomes between trans­trocar appendix removal
laparoscopic appendectomy. group (TTAR) and disposable specimen vinyl bag group
Keywords: Appendectomy, Laparoscopy, Specimen removal. (DSVB) and to identify the better way to removal of
How to cite this article: Bae JM. Clinical Experiences of Trans- resected appendix in laparoscopic appendectomy.
Trocar Appendix Removal in Laparoscopic Appendectomy.
World J Lap Surg 2014;7(3):107-110. MATERiALS And METhodS
Source of support: Nil
The subjects were the patients in this hospital who diag­
Conflict of interest: None
nosed acute appendicitis between January 2013 and
December 2013. Complicated appendicitis patients that
inTRoduCTion
diagnosed as perforated appendicitis or periappendiceal
Acute appendicitis is one of the most frequent emer­ abscess by preoperative abdominal computed tomo­
gency operations in general surgery. Traditionally, acute graphy, abdominal ultrasonography or intraoperatively
operative findings were excluded.
Retrospective analysis was carried out based on the
Professsor records made after surgery regarding clinical characte­
Department of General Surgery, Yeungnam University Medical ristics such as operative time, hospital stay, complications,
Center, Korea readmission and additional analgesics.
Corresponding Author: Jung Min Bae, Professor, Department SPSS 12.0 (SPSS Inc, Chicago, IL, USA) used for statis-
of General Surgery, Yeungnam University Medical Center tical analysis. Student t­test for average analysis and
Korea, Phone: 82536203580, e-mail: netetern@naver.com
Fisher’s exact test for cross tabulation analysis was used.
World Journal of Laparoscopic Surgery, September-December 2014;7(3):107-110 107