Can laparoscopic appendectomy be safely performed by surgeons who are less experienced in intraabdominal knot-tying?

Abstract

Introduction: The aim of this study was to compare the handmade sailor's knot method with the intracorporeal knot method used to close the appendix stump. Materials and Methods: The files of 47 patients who were operated on for acute appendicitis between January 2017 and January 2019 were analyzed retrospectively. The patient records were analyzed in terms of age, gender, type of laparoscopic surgery, length of hospital stay, and postoperative complications. The patients were divided into 2 groups: patients ligated with the sailor's knot method and a prepared loop (Group 1) and intracorporeally ligated patients (Group 2). Results: Of the 47 patients included in the study, 24 were male (51%) and 23 were female (49%). In Group 1, 15 (55.5%) patients were male and 12 (44.5%) patients were female. In Group 2, there were 9 (45%) male patients and 11 (55%) female patients. The mean length of hospitalization of the patients in Group 1 was 3±1.68 days, while it was 2.95±1.13 days in Group 2. The duration of surgery was 73.70±31.76 minutes in Group 1, while it was 70.75±27.25 minutes in Group 2. There was no statistically significant difference between the 2 groups in terms of the length of hospitalization or the duration of surgery. Conclusion: A handmade sailor' knot is an easy, reliable, and cost-effective method to close the appendix stump in patients undergoing laparoscopic appendectomy. The technique can be used safely when intracorporeal knot-tying or suturing cannot be performed.