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Multicenter Study
. 2025 Jun;39(6):3814-3820.
doi: 10.1007/s00464-025-11743-z. Epub 2025 May 6.

Using the endoscopic snare to facilitate two-port laparoscopic appendectomy

Mohamed Farid  1 , Azza Baz  2 , Mohamed Riad  3 , Ashraf Abdelmonem Elsayed  3 , Ahmed Salah Arafa  3 , Rasha S Elsayed  3 , Alaaedin Ramadan  3 , Ibrahim A Heggy  3 , Mostafa M Elaidy  3
Affiliations
Multicenter Study

Using the endoscopic snare to facilitate two-port laparoscopic appendectomy

Mohamed Farid et al. Surg Endosc. 2025 Jun.

Abstract

Background: Laparoscopic appendectomy is now the gold-standard treatment for acute appendicitis, requiring three ports for a classic procedure. Recent laparoscopy improvements aim to minimize surgical trauma and improve cosmetic quality through smaller, fewer portal incisions, such as two-port laparoscopic appendectomy, resulting in reduced postoperative pain. We aimed in this study to describe a novel technique to facilitate two-port laparoscopic appendectomy using the endoscopic snare.

Patients and methods: The data for a total of 85 patients, who underwent the two-port laparoscopic appendectomy using the endoscopic snare, at two research centers in Zagazig city, Egypt, from July 2022 till July 2023, is retrospectively analyzed. Overall length of hospital stay was the primary outcome, and the duration of operation and patient cosmetic satisfaction were secondary endpoints.

Results: All the 85 laparoscopic procedures were completed without difficulty. The mean operative time was 43.78 ± 8.46 min (minimum: 34 min, maximum: 57 min). Length of hospitalization was 1.12 ± 0.74 days (min: 1 day, max: 2 days). No major complications were encountered. Four cases of minor postoperative complication occurred, in which the patient developed port site infection, which was completely resolved at one week postoperatively.

Conclusion: Laparoscopic appendectomy, using only two ports and endoscopic snare, is generally feasible and has been linked to high patient satisfaction and excellent cosmetic outcomes.

Keywords: Endoscopic snare; Laparoscopic appendectomy; Novel approach; Two ports.

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Conflict of interest statement

Declarations. Disclosure: All authors have no conflicts of interest. Ethical approval: Approval for this study was granted by the Institutional Review Board of the Zagazig University, with an IRB registration number is ZU-IRB#759/8–12-2024. Informed consent: A full written-informed consent was obtained from any adults participating in this study and is available upon request.

Figures

Fig. 1
Fig. 1
The flowchart for the allocation process throughout the study
Fig. 2
Fig. 2
Alongside the 5-mm suprapubic trocar, the same skin incision was used to introduce the endoscopic snare
Fig. 3
Fig. 3
With the aid of the endoscopic snare the appendix was readily and successfully manipulated, just like an endo-grasper
Fig. 4
Fig. 4
A 5-mm endoscopic titanium or polymer endo-clips were used to ligate the appendix near its base
Fig. 5
Fig. 5
a and b The 5-mm port instrument facilitated this process of snare appendicular suspension by guiding and encircling the appendix
See this image and copyright information in PMC

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