No Clip, No Ligature Laparoscopic Appendectomy

Laparoscopic appendectomy (LA) is one of the common procedures being carried out in general surgery. The technique of bipolar coagulation (BC) has been effectively employed in obstetric and gynecologic procedures but has not been used for intestines. We present the technique of LA using BC at our center. The technique consisted of identifying the appendix and coagulating the appendicular stump with bipolar coagulation until there were no bubbles at the cautery site, and a constriction ring formed at the site of coagulation. Sixty patients with acute or recurrent appendicitis underwent the procedure. The median duration of BC was 90 seconds. The median duration of surgery was 25 minutes, postoperative hospital stay was 3 days, and time to oral feeds was 12 hours. The technique of laparoscopic appendectomy by bipolar coagulation is very simple and economical. The duration of surgery is less than for the standard technique of laparoscopic appendectomy; no clip applicators, needle holders or knot pushers are required, and no foreign materials like ligatures or clips are needed.