Article Text

PTU-173 Feasibility study of safety and cost effectiveness of using johan forceps as endoloop pushers for laparoscopic appendicectomy
  1. K Siddique1,
  2. K Khan2,
  3. T Offori2
  1. 1General Surgery, Mid Yorkshire Hospitals NHS Trust, Dewsbury
  2. 2General Surgery, Barnsley Hospital NHS Trust, Barnsley, UK


Introduction Background: The base of appendix can be secured using endoloops or endoscopic stapler. The authors have reported the use of Johan forceps as endoloop pushers for laparoscopic appendicectomy.

Method Aims: To evaluate the safety and cost effectiveness of this technique.

Patients and methods: A prospectively collected data of all patients who underwent laparoscopic appendicectomy by this technique between 2012 till 2014 was reviewed. Base of the appendix was secured using three standard extra-corporeal endoloops deployed with Johan’s forceps utilising one vicryl tie. Demographics, operative findings, post-operative complications and readmissions were recorded and analysed.

Results Total number of patients was 120. There were 72 (60%) males while rest were female with an age of *24 (14–77). Grossly inflamed appendix (including perforation, localised abscess) was noted in 76% of cases. No peri-operative complications were reported. The post-op stay was *2 (1–5) days (* represents median). Complications include 7 (5.8%) wound infections which were managed conservatively. 9 patients were re-admitted due to reasons unrelated to the surgical technique. The cost of one vicryl tie was £0.5 Vs £49.80 (for 3 standard endoloops available in the market). The cost analysis showed johan assisted appendicectomy to be 99 times cheaper than the standard marketed endoloops.

Conclusion Our series involving various surgeons employing the standard technique of using the Johan forceps as endoloop knot pushers shows that it is a feasible and safe technique with promising results. The technique has been practised in various hospitals and provides a cheap and safe alternative to the standard endoloops available in the market.

Disclosure of interest None Declared.

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.