World Journal of Laparoscopic Surgery

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VOLUME 16 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Omental Wrapping of the Cecum and Appendix Stump Reduces Postoperative Pain and Speeds Recovery after Laparoscopic Appendectomy: A Prospective Randomized Controlled Trial

Maged Rihan

Keywords : Laparoscopic appendectomy, Omental wrapping, Postoperative pain, Randomized controlled trial

Citation Information : Rihan M. Omental Wrapping of the Cecum and Appendix Stump Reduces Postoperative Pain and Speeds Recovery after Laparoscopic Appendectomy: A Prospective Randomized Controlled Trial. World J Lap Surg 2023; 16 (3):158-162.

DOI: 10.5005/jp-journals-10033-1586

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Many factors contribute to pain after laparoscopic appendectomy. We devised a method to reduce pain after laparoscopic appendectomy by wrapping the cecum with the greater omentum. This study aimed to investigate the effectiveness of this method. Materials and methods: This study was conducted to compare the operative and postoperative outcomes in patients with omental wrapping and traditional laparoscopic appendectomy patients. The primary endpoints were the degree of postoperative intra-abdominal pain intensity evaluated by visual analogue scale (VAS), and analgesic use. The secondary endpoints were the operation time, time to pass gas, white blood cell count, C-reactive protein (CRP) on the second postoperative day, numerical rating scale for postoperative nausea, frequency of antiemetic medications frequency, and length of hospital stay. The study was registered in the International Standard Randomised Controlled Trial Number (ISRCTN) registry (ISRCTN 89363255). Results: This study evaluated 106 patients. Fifty patients were assigned to the traditional group and 56 to the wrapping group. Pain scores in the first postoperative 24 hours were significantly higher in traditional group patients (p = 0.007). Between 24 and 48 hours, pain score was also higher in traditional group patients (p = 0.01). Time to pass gas was achieved earlier in the wrapping group (p < 0.001). Conclusion: Omental wrapping of the cecum and appendix stump in laparoscopic appendectomy can provide postoperative pain relief by reducing the intensity of visceral pain.

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