The use of endo-loop is as safe as the use of staplers for Closure of the Appendiceal stump in Laparoscopic appendectomy

Awadelkarim O Mohamed, MD¹, Jawahir Al Tunaji, MD¹, Talat Al Shaban, MD², Hazaa Osman, MD², Abdelrahman A Nimeri, MD, FACS, FASMBS². ¹Surgery Residency Program UAE, ²Sheikh Khalifa Medical City

Introduction:

In effective appendiceal stump closure in laparoscopic appendectomy (LA) can lead to intra-abdominal abscess formation or peritonitis .This study is aimed at comparing two methods for appendiceal stump closure; stapled versus endoloop closure in laparoscopic appendectomy.

Methods:

We reviewed all medical records of all LA performed by all surgeons in the division of General, Thoracic and Vascular Surgery from January 1st 2011 to December 31st 2013. The primary outcome variable is the development of intraabominal collection and secondary outcome variables include duration of surgery, hospital stay and costs.

Results:

During the study period, 340 LA were peformed. Acute appendicitis represented 97% of our LA, and 84% of our patients had non-perforated Appendicitis. The method of appendiceal stump closure was endoloop and laparoscopic linear stapler in 60% and 40% respectively. The rate of intra-abdominal collection after using a stapler or an endoloop was not statistically significantly different (2.2% vs 1.4 % p>0.05). In addition, the LOS was equal in both groups. The use of endo loops was cheaper than the use of staplers to secure the appendiceal stump.

Conclusions:

Use of endo-loop to secure the appendiceal stump during LA is a simple, safe effective, and cheap method compared to the use of stapling without an increase in the rate of intraabominal collections or LOS.

Key words: Laparoscopic appendectomy, Stump closure, Endo-loop, stapled