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A New Knot Pusher Used in Laparoscopic Appendectomy; Karman Cannula

Yıl 2020, , 23 - 27, 16.03.2020
https://doi.org/10.31832/smj.638492

Öz

Objective:
Laparoscopic
appendectomy is now becoming the gold standard for the treatment of acute
appendicitis. Besides, high-cost devices used during the process, the
reliability, availability, and cost of the materials used in closing the
appendix stump are also important. In this study, we aim to prove that the
appendix stump can be secured reasonably and effectively by the guidance of the
Karman cannula with a hand-prepared knot.

Materials
and Methods:
In our descriptive
study, the Karman cannula used as a knot pusher which can be easily found in
every operating room in laparoscopic appendectomies performed between March
2018 and September 2018 in our clinic.

Results:
157 males (64,9%) and
85 females (35,1%) included in the study. All patients underwent laparoscopic
appendectomy, and the mean operation time was 31.9
± 10 minutes. All patients discharged on the first
postoperative day. Surgical site infection observed in five (2%) patients.







Conclusion:
The Karman cannula can be used as a safe and
inexpensive knot pusher in laparoscopic appendectomies

Kaynakça

  • 1. Addis's DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990; 132: 910-925.
  • 2. Novak E. The diagnostic and therapeutic application of uterine suction curette. Surgery. 1937;1:610-612.
  • 3. Adinma JIB, Okpala OC. Hysterosalpingogram in the management of infertility: bilateral tubal occlusions. West African Journal of Radiology. 1993.
  • 4. Mantoğlu B, Karip B, Mestan M, et al. Should appendectomy be performed laparoscopically? Clinical prospective randomized trial. Ulus Cerrahi Derg. 2015;31(4):224–28.
  • 5. Arcovedo R, Barrera H, Reyes HS. Securing the appendiceal stump with the Gea extracorporeal sliding knot during laparoscopic appendectomy is safe and economical.Surg Endosc 2007;21:1764-7.
  • 6. Wagner M, Aronsky D, Tschudi J, Metzger A, Klaiber C. Laparoscopic stapler appendectomy: a prospective study of 267 consecutive cases. Surg Endosc 1996;10:895-9.
  • 7. Partecke LI, von Bernstorff W, Karrasch A, Cziupka K, Glitsch A, Stier A, et al. Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis. Langenbecks Arch Surg 2010;395:1069-76.
  • 8. Delibegovic S, Matovic E. Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg Endosc 2009; 23:2851-4.
  • 9. Delibegovic S. The use of a single Hem-o-lok clip in securing the base of the appendix during laparoscopic appendectomy. J Laparoendosc Adv Surg Tech A 2012; 22:85-7.
  • 10. Rickert A, Krüger CM, Runkel N, et al. The TICAP-Study (titanium clips for appendicular stump closure): A prospective multicentre observational study on appendicular stump closure with an innovative titanium clip. BMC Surg. 2015;15:85.
  • 11. Hüseyin Kerem Tolan, Gürhan Baş, Fikret Ezberci, Tolga Canbak, Adnan Özpek, Abdullah Şişik, Metin Yücel, Ilyas Kudaş, Ibrahim Atak. The safety and efficacy of different methods used for the closure of the appendiceal stump in laparoscopic appendectomy. Laparosc Endosc Surg Sci . 2017; 24(3):77-80.
  • 12. Chang Sik Hue, Jin Su Kim, Ki Hoon Kim, et al. The usefulness of Hem-o-lok clips fort the closure of appendicular stump during laparoscopic appendectomy. J Korean Surg Soc 2013; 84:27-32.
  • 13. Kazemier G, in’t Hof KH, Saad S, Bonjer HJ, Sauerland S. Securing the appendiceal stump in laparoscopic appendectomy: Evidence for routine stapling? Surg Endosc. 2006; 20:1473–6.
  • 14. Strzałka M, Matyja M, Rembiasz K. Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump. World J Emerg Surg. 2016 6;11:4.
  • 15. Swank HA, Van Rossem CC, Van Geloven AAW, In’t Hof KH, Kazemier G, Meijerink WJHJ, et al. Endostapler or endoloops for securing the appendiceal stump in laparoscopic appendectomy: a retrospective cohort study. Surg Endosc. 2014;28:576-83.
  • 16. Beldi G, Vorburger SA, Bruegger LE, Kocher T, Inderbitzin D, Candinas D. Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg. 2006; 93:1390–3.
  • 17. Sajid MS, Rimple J, Cheek E, Baig MK. Use of endo-GIA versus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review. SurgLaparosc Endosc Percutan Tech. 2009; 19:11–15.
  • 18. Ali N, Javaid A: Role of tube cecostomy in preventing post appendectomy abscess and fistula formation. Pak J Med Sci. 2005; 21:285-8.
  • 19. Finlay DJ, Doherty GM: Acute abdominal pain and appendicitis. In: Washington Manual of Surgery. Washington University School of Medicine. Lippincott Williams & Wilkins; 2002; 265.

Laparoskopik Appendektomide Yeni Bir Düğüm Oturtucu; Karman Kanülü

Yıl 2020, , 23 - 27, 16.03.2020
https://doi.org/10.31832/smj.638492

Öz

Giriş: Laparoskopik
apendektomi günümüzde, akut apandisitin tedavisinde altın standart olma yolunda
ilerlemektedir. Bunun yanı sıra işlemin gerçekleşmesi sırasında maliyeti yüksek
cihazlar kullanılmaktadır. Apendiks güdüğünün kapatılması noktasında da
kullanılan malzemelerin güvenirliliği, bulunabilirliği ve maliyeti önem arz
etmektedir.
Bu çalışmada, apendiks
güdüğünü elle hazırlanmış düğüm ve Karmen kanülünü düğüm oturtucu olarak
kullanarak, apendiks güdüğünün güvenli bir şekilde kapatılabileceğini
göstermeyi amaçladık.

 

Gereç ve Yöntemler: Tanımlayıcı
türde  olan çalışmamızda, kliniğimizde
Mart 2018 ve Eylül 2018 tarihleri arasında yapılan laparoskopik
apendektomilerde, apendiks güdüğünü kapatmak için kullandığımız ve her
ameliyathanede kolaylıkla bulunabilen Karman kanülü düğüm oturtucu olarak
kullanıldı.

Bulgular:Çalışmaya
157 erkek (%64,9) 85 kadın (%35,1) toplam 242 hasta dahil edildi. Tüm
hastaların ameliyatları laparoskopik olarak yapıldı ve açık ameliyata
konversiyon olmadı. Ortalama ameliyat süresi 31,9 ± 10 dakikaydı. Hastaların
tümü post operatif birinci gün taburcu edildi. Beş hastada (%2) cerrahi alan
enfeksiyonu oluştu.









Sonuç: Karman kanülü
laparoskopik apendektomide diğer güdük kapama yöntemleri gibi güvenli ve ucuz
bir düğüm oturucu olarak kullanılabilir.

Kaynakça

  • 1. Addis's DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990; 132: 910-925.
  • 2. Novak E. The diagnostic and therapeutic application of uterine suction curette. Surgery. 1937;1:610-612.
  • 3. Adinma JIB, Okpala OC. Hysterosalpingogram in the management of infertility: bilateral tubal occlusions. West African Journal of Radiology. 1993.
  • 4. Mantoğlu B, Karip B, Mestan M, et al. Should appendectomy be performed laparoscopically? Clinical prospective randomized trial. Ulus Cerrahi Derg. 2015;31(4):224–28.
  • 5. Arcovedo R, Barrera H, Reyes HS. Securing the appendiceal stump with the Gea extracorporeal sliding knot during laparoscopic appendectomy is safe and economical.Surg Endosc 2007;21:1764-7.
  • 6. Wagner M, Aronsky D, Tschudi J, Metzger A, Klaiber C. Laparoscopic stapler appendectomy: a prospective study of 267 consecutive cases. Surg Endosc 1996;10:895-9.
  • 7. Partecke LI, von Bernstorff W, Karrasch A, Cziupka K, Glitsch A, Stier A, et al. Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis. Langenbecks Arch Surg 2010;395:1069-76.
  • 8. Delibegovic S, Matovic E. Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg Endosc 2009; 23:2851-4.
  • 9. Delibegovic S. The use of a single Hem-o-lok clip in securing the base of the appendix during laparoscopic appendectomy. J Laparoendosc Adv Surg Tech A 2012; 22:85-7.
  • 10. Rickert A, Krüger CM, Runkel N, et al. The TICAP-Study (titanium clips for appendicular stump closure): A prospective multicentre observational study on appendicular stump closure with an innovative titanium clip. BMC Surg. 2015;15:85.
  • 11. Hüseyin Kerem Tolan, Gürhan Baş, Fikret Ezberci, Tolga Canbak, Adnan Özpek, Abdullah Şişik, Metin Yücel, Ilyas Kudaş, Ibrahim Atak. The safety and efficacy of different methods used for the closure of the appendiceal stump in laparoscopic appendectomy. Laparosc Endosc Surg Sci . 2017; 24(3):77-80.
  • 12. Chang Sik Hue, Jin Su Kim, Ki Hoon Kim, et al. The usefulness of Hem-o-lok clips fort the closure of appendicular stump during laparoscopic appendectomy. J Korean Surg Soc 2013; 84:27-32.
  • 13. Kazemier G, in’t Hof KH, Saad S, Bonjer HJ, Sauerland S. Securing the appendiceal stump in laparoscopic appendectomy: Evidence for routine stapling? Surg Endosc. 2006; 20:1473–6.
  • 14. Strzałka M, Matyja M, Rembiasz K. Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump. World J Emerg Surg. 2016 6;11:4.
  • 15. Swank HA, Van Rossem CC, Van Geloven AAW, In’t Hof KH, Kazemier G, Meijerink WJHJ, et al. Endostapler or endoloops for securing the appendiceal stump in laparoscopic appendectomy: a retrospective cohort study. Surg Endosc. 2014;28:576-83.
  • 16. Beldi G, Vorburger SA, Bruegger LE, Kocher T, Inderbitzin D, Candinas D. Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg. 2006; 93:1390–3.
  • 17. Sajid MS, Rimple J, Cheek E, Baig MK. Use of endo-GIA versus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review. SurgLaparosc Endosc Percutan Tech. 2009; 19:11–15.
  • 18. Ali N, Javaid A: Role of tube cecostomy in preventing post appendectomy abscess and fistula formation. Pak J Med Sci. 2005; 21:285-8.
  • 19. Finlay DJ, Doherty GM: Acute abdominal pain and appendicitis. In: Washington Manual of Surgery. Washington University School of Medicine. Lippincott Williams & Wilkins; 2002; 265.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Barış Mantoğlu 0000-0002-2161-3629

Fatih Altıntoprak 0000-0002-3939-8293

Emre Gönüllü Bu kişi benim 0000-0001-6391-4414

Emrah Akın Bu kişi benim 0000-0003-0224-3834

Kayhan Özdemir 0000-0002-8041-198X

Ali Muhtaroğlu 0000-0001-5412-2175

Yayımlanma Tarihi 16 Mart 2020
Gönderilme Tarihi 26 Ekim 2019
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

AMA Mantoğlu B, Altıntoprak F, Gönüllü E, Akın E, Özdemir K, Muhtaroğlu A. A New Knot Pusher Used in Laparoscopic Appendectomy; Karman Cannula. Sakarya Tıp Dergisi. Mart 2020;10(1):23-27. doi:10.31832/smj.638492

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