Despite the reported advantages of laparoscopic appendectomy (LA), an ongoing debate exists about a possible increase in postoperative infectious complication rates. The analyses of risk factors associated with surgical site infections (SSIs) after LA, have been limited.

One hundred twenty laparoscopic appendectomies performed over one year, were included in this retrospective study. The patients were divided into 2 group; group A was the one in which LA was done with using reusable retrieval bag and group B without using that. Demographic details, operative time, hospital stay and infective postoperative complications were recorded.

This patient groups were selected to be similar in both groups A and B in form of appendicitis types. Each group included 27 (45%) acute catarrhal appendicitis, 20 (33.3%) suppurative appendicitis and 13 (21.7%) perforated appendicitis, P = 1.0. The median patients ages were 21 years (range, 16 to 49) in group A and 25 years (range, 18 to 56) in group B, P = 0.053. Group A included 60 patients (35 males and 25 females) and group B 60 patients (32 males and 28 females), P = 0.071. Mean operative time in group A was 55.7 minutes and in group B was 57 minutes, P = 0.0231. Superficial wound infections were recorded in one patient (1.7%) in group A and in 8 patients (13.3%) in group B, P = 0.007. Intra-abdominal abscess formation was a complicated outcome in 2 patients (3.3%) of group B, P = 0.005. Mean hospital stay was 1.6 days in group A and 2.7 days in group B, P = 0.05.

Surgical wound infections are less common by using reusable retrieval bag during laparoscopic appendectomy procedure. Also, using reusable retrieval bag has less cost.

Laparoscopic appendicectomy is safe and feasible for non-complicated appendicitis. The use of retrograde appendicectomy allows feasibility also for complicated cases. Using single polymer clip for securing appendicular stump is safe as well as two clips.

To evaluate the clinical outcome of using single Hem-O-Lock polymer clip and to compare technical feasibility of retrograde laparoscopic appendicectomy for complicated versus non-complicated appendicitis in adults.

A single institute prospective study was done between August 2012 and April 2014. From 78 patients presenting with acute appendicitis to emergency unit, Zagazig University hospitals, only 60 patients were eligible. Three retrograde laparoscopic appendicectomy ports were used in both groups (group I, complicated appendicitis and group II, non-complicated appendicitis) and a single Hem-O-Lock polymer clip was applied to secure the appendicular stump. Standardized data collection was performed and data collected by the attending resident and attending physician. The primary clinical outcome was the severity of pain at 1 - 7 days. Secondary outcomes included the duration of operation (minutes), procedure-related complications, conversion rates, and length of hospital stay.

Four patients (15.4%) were converted to open surgery; three patients in group I and one in group II. Four patients developed postoperative complications; three patients in group I and one in group II. Operative time was less in group II and was statistically different and the P value was significant < 0.001. The difference in conversion rates and post-operative complication between two groups is not statistically significant with a P > 0.05.

Retrograde laparoscopic appendicectomy using single polymer clip makes easy access to operating in complicated and non-complicated appendicitis.