Cost Effectiveness of Different Methods of Appendiceal Stump Closure during Laparoscopic Appendectomy

There is no standard method for closure of an appendiceal stump during laparoscopic appendectomy. This study compares stump closure using a stapler with closure using an Endoloop ligature. The charts of all patients who underwent laparoscopic appendectomy at a single tertiary care center over a two-year period were reviewed for demographics, comobidities, operative details and costs, and outcomes. There were 325 patients who underwent a laparoscopic appendectomy. The majority, 250 (77%), underwent stump closure with a stapler. They were equivalent in demographics and postoperative complication rates. Cases using an Endoloop were slightly faster in terms of procedure time and room time, and less expensive in terms of operative supply cost. The price difference is not explained by time saved in the operating room and more likely by the equipment price.