Appendiceal Base Ligation With The Hand-Made Polydioxanone (Pds) Extracorporeal Knot

Objective: This study describes our experience with a low cost handmade polydioxanone (PDS) extracorporeal knot to reduce the cost of laparoscopic appendectomy in a surgical practice. Methodology: This retrospective study was conducted from January 2018 to December 2019 in a general surgical unit of the University College Hospital Ibadan. The files of 20 patients with complete data for whom extracorporeal hand-made PDS’0’ knots were used for appendiceal stump closure during laparoscopic appendectomy were retrieved. Results: The mean age was 28.4 ± 13.2 years. There were nine male and eleven female patients. All the operations were performed by the same surgical team. The mesoappendix was coagulated with bipolar cautery and cut with scissors. The appendix base was double ligated with two extracorporeal knots and divided. The mean duration of surgery was 59.2 ± 31.2minutes. The median length of hospital stay was 2days. The mean duration of follow up was 2.80 ± 0.50 months. One patient developed superficial port site infection. Conclusion: The handmade extracorporeal knot used in this retrospective study for securing appendicular stump was found to be safe and cheaper than pre-tied extracorporeal loop. This will reduce dependency upon preformed endoloops making the procedure cheaper. There was no incidence of failed application of the handmade extracorporeal knot.