Laparoscopic appendicectomy in children: specimen coiling prevention using safe and simple technique to retrieve the appendix in a glove finger

Main Article Content

Abdelbasit E. Ali
Motaip H. Alrawili



Background Removal of the appendix from the peritoneal cavity following laparoscopic appendicectomy (LA) can be challenging. Several techniques have been described to extract the appendix. The use of a glove finger to remove the appendix is well known, however, it may prove to be difficult due to coiling and clubbing of the appendix inside the glove finger at the exit site. Occasionally the glove finger is damaged during this procedure with a resultant wound soiling and potentially wound infection.


Objectives To enable easy retrieval of the appendix and avoid complications.


Methods The 3rd Endo-loop ligature - that is coming out with the appendix - is left long and grasped to facilitate keeping the appendix straight during its removal in the glove finger. The records of all the children who underwent LA using this modified technique in our department in the period between February 2017 and March 2020 were reviewed retrospectively.


Results In 48 cases out of 151 LA, the appendix was extracted using this technique. Their ages ranged between 2-13 years. Complications related to the technique were observed in three patients (6.25%), one patient had a slipped ligature and two patients had fragmented necrotic appendices.


Conclusion Leaving a long ligature on the specimen is a simple, safe, inexpensive, easy and effective technique to control, straighten and retrieve the appendix in a glove finger.

Article Details

Original Articles



1. Alder AC, Minkes RK. Paediatric appendicitis: treatment and management. www.medscape. com, updated: Oct 25, 2018. Cited March 31,

2. Jain PK, Sedman P. Appendix retrieval after laparoscopic appendectomy: a safe and

inexpensive technique. Surg Laparosc Endosc
Percutan Tech 2003;13:322–324

3. Sagaon MM, Hamitaga F, Hurnilow Y.
Appendix extraction after laparoscopic appendectomy in children: An easy, safe, and inexpensive technique. Journal of Paediatric Surgery 2016;51(2):341–343.

4. Nazir S, Bulanov A, Shanazarian M, Magruder JK. Glove-finger extraction technique for laparoscopic appendectomy:high-quality cost- conscious surgery. Society of the American Gastrointestinal and Endoscopic (SAGE) surgeons. 2016 Jan.

5. Saad M. Fisherman’s technique, introducing a novel method for using the umbilical port for removal of appendix during laparoscopic appendectomy. Surg Laparosc Endosc Percutan Tech 2007;17(5):422-4.

6. Fields AC, Lu P, Palenzuela DL, Bleday R, Goldberg JE, Irani J, et al. Does retrieval bag use during laparoscopic appendectomy reduce postoperative infection? Surgery

7. Mazziotti MV, Minkes RK. Paediatric appendectomy. Updated: Nov 12, 2015, Cited March 30, 2020.

8. Jung CY, Bae JM. Trocar size selection for trans-trocar appendix removal in laparoscopic appendectomy. J Minim Invasive Surg
2014;17(1):1-4 /10.7602 /jmis.