Suture grasper (Endo Close) versus simple closure of the umbilical port site in laparoscopic appendectomy in children

Abstract Introduction: This prospective randomised study compared two umbilical port-site closure techniques in paediatric laparoscopic appendectomy: The suture grasper (Endo Close) and simple closure. The primary outcome was post-operative pain at the umbilical port site over the first five post-operative days, and the secondary outcome was the incidence of port-site hernia at 2 weeks, 2 months and 6 months postoperatively. Patients and Methods: One hundred children (mean age 10.5 years) undergoing laparoscopic appendectomy for acute non-complicated appendicitis were randomised into two groups: Endo Close ( n = 50) and simple closure ( n = 50). Pain scores (1–10 scale) were recorded daily for 5 days postoperatively, and port-site hernias were assessed during the follow-up visits. Statistical analysis included repeated-measures ANOVA and Chi-square tests. Results: No significant differences were observed in post-operative pain scores between the Endo Close and simple closure groups ( P > 0.05). Pain scores declined similarly in both groups from day 1 (Endo Close: 6.8 ± 2.1; simple closure: 6.2 ± 2.3) to day 5 (Endo Close: 1.8 ± 1.6; simple closure: 1.2 ± 1.6). No port-site hernias were detected in either group during the 6-month follow-up period. Conclusion: The Endo Close device is comparable to simple closure in terms of post-operative pain and port-site hernia incidence in paediatric laparoscopic appendectomy. Larger multicentre studies with a longer follow-up are needed to confirm the long-term outcomes and further define its role in paediatric laparoscopic surgery.