Comparison Among Different Closure Methods of the Appendicular Stump in Laparoscopic Appendectomy

Area of Science:

• Surgical Procedures
• Gastrointestinal Surgery

Background:

• Appendectomy is the most common surgery for acute abdomen.
• Laparoscopic appendectomy is the predominant surgical approach.
• Effective appendicular stump closure is critical for patient outcomes.

Purpose of the Study:

• To compare the efficacy and cost-effectiveness of three appendicular stump closure techniques: endo-stapler, endo-loop, and clip.
• To evaluate the handling characteristics and limitations of each method.

Main Methods:

• Review of current literature on appendicular stump closure techniques.
• Comparative analysis of endo-stapler, endo-loop, and clip based on cost, handling, and applicability.
• Discussion of clinical scenarios favoring each technique.

Main Results:

• Endo-stapler is expensive but offers combined closure and transection, with applicability in inflamed bases and potential for cecal resection.
• Endo-loop and clip are cost-effective; clip is simpler to handle but limited to appendices ≤16 mm in diameter.
• The endo-loop does not share the size limitation of the clip.

Conclusions:

• The choice of appendicular stump closure technique involves balancing cost, handling ease, and anatomical considerations.
• Each method (endo-stapler, endo-loop, clip) presents unique advantages and disadvantages for laparoscopic appendectomy.