Ali Iyoob V, Maliekkal Joji I
Department of General Surgery, Medical College, Calicut, Kerala, India.
Saudi J Gastroenterol. 2009 Jan;15(1):39-41. doi: 10.4103/1319-3767.45053.
BACKGROUND/AIM: Wider adoption of laparoscopic appendicectomy (LA) is limited by problems in securing the appendiceal base as well as the cost and the duration compared with the open procedure. The objective of this study was to assess the feasibility and efficacy of a new method for securing the appendiceal base in LA, so as to make the entire procedure simpler and cheaper, and hence, more popular.
Twenty-five patients who were candidates for appendicectomy (emergency as well as elective) and willing for the laparoscopic procedure were selected for this study. Ports used were 10 mm at the umbilicus, 5 mm at the lower right iliac fossa, and 10 mm at the left iliac fossa. Extremely friable, ruptured, or turgid organs of diameters larger than 8 mm were excluded from the study. The mesoappendix was divided close to the appendix by diathermy. Fallope rings were applied to the appendiceal base using a special ring applicator, and the appendix was divided and extracted through the lumen of the applicator.
The procedure was successful in 23 (92%) cases, and the mean duration of the procedure was 20 minutes (15-32 minutes). There were no procedural complications seen during a median follow-up of two weeks. The equipment and rings were cheaper when compared with that of the standard methods of securing the base of the appendix.
LA using fallope rings is a safe, simple, easy-to-learn, and economically viable method.
背景/目的：与开放手术相比，腹腔镜阑尾切除术（LA）在更广泛应用方面受到阑尾根部固定问题以及成本和手术时间的限制。本研究的目的是评估一种在LA中固定阑尾根部的新方法的可行性和有效性，以使整个手术更简单、成本更低，从而更受欢迎。
本研究选取了25例阑尾切除术候选患者（包括急诊和择期），他们愿意接受腹腔镜手术。使用的端口分别为脐部10mm、右下腹5mm和左下腹10mm。直径大于8mm的极度脆弱、破裂或肿胀的器官被排除在研究之外。通过电凝将阑尾系膜在靠近阑尾处分开。使用特殊的环套器将法洛皮环（Fallope环）应用于阑尾根部，然后通过环套器的内腔将阑尾切断并取出。
该手术在23例（92%）患者中成功，手术平均时长为20分钟（15 - 32分钟）。在两周的中位随访期内未观察到手术并发症。与固定阑尾根部的标准方法相比，该设备和环更便宜。
使用法洛皮环的LA是一种安全、简单、易于学习且经济可行的方法。
