Laparoscopic Stapler Appendicectomy - Dr. R.K. Mishra

Laparoscopic Stapler Appendicectomy

The stapling devices make laparoscopic appendectomy simpler and faster. The multi-fire stapler is introduced through a 12 mm port. The appendix may be transacted by inserting an ENDO GIA instrument via the RUQ trocar (blue cartridge, 3.5), closing it around the base of the appendix, and firing it. For perforated appendicitis with or without an intraabdominal abscess, a drain is left in the RLQ and pelvis. Extracorporeal knot (Meltzer, Roeder, or Tayside knot) should be preferred over a stapler, depending on the surgeon's expertise.

Stapler AppendicectomyStapler Appendicectomy

Traditionally this requires a larger 10mm port to accommodate the laparoscopic stapler appendectomy, increasing the risk of port-site complications, such as incisional hernia, and post-operative pain, which impedes same-day discharge in otherwise eligible patients. The JustRight™ 5mm endoscopic stapler is designed for the small working space encountered in pediatric minimally invasive surgery.  In this case series, the JustRight™ 5mm stapler was used to limit port size in patients undergoing emergency laparoscopic appendectomy.

5 MM laparoscopic Stapler

The JustRight™ 5mm stapler can be employed safely for laparoscopic appendectomy in patients regardless of age or size, with potentially beneficial effects on postoperative analgesia requirements and hospital stay, and avoiding the need for 10mm port-sites. Successful use is determined by the size of the appendix base.

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