Endoloop Slippage after Emergency Appendectomy: Endoscopic Clip Placement as a Rescue Technique in a Complex Case – with Video
摘要
Acute appendicitis is one of the most common causes of abdominal pain, and laparoscopic appendicectomy is widely regarded as the standard treatment. A crucial and technically challenging part of the procedure is the management and secure closure of the appendiceal stump, especially in complex cases. Although the endo-loop is widely preferred for its simplicity and cost-effectiveness, it can still have complications. Here, we report a rare postoperative complication involving endo-loop slippage following laparoscopic appendectomy. A young woman underwent emergency laparoscopic appendectomy for acute appendicitis. On postoperative day (POD) 7, she returned to the emergency department with fever and abdominal pain. Exploratory laparoscopy revealed an intra-abdominal abscess and appendiceal stump dehiscence. A 2.8 mm endoscopic clip was successfully deployed to achieve stump closure. The patient was discharged on POD 4 without further complications. This case demonstrates that the use of endoscopic instruments, combined with advanced laparoscopic skills, can provide a viable and safe alternative in complex intraoperative findings. The endoscopic clip improved maneuverability and directional control, enabling secure stump ligation. This case highlights the importance of technical adaptability and innovation in minimally invasive surgery, especially when conventional methods prove inadequate.