Endostapler vs Endoloop Closure of the Appendiceal Stump in Laparoscopic Appendectomy: Which Has Better Outcomes?

Document Type

Article

Publication Date

8-2021

Abstract

Background

In laparoscopic appendectomy (LA), closure of the appendiceal stump can be achieved using either an endostapler or endoloop. We compared outcome data from utilizing either technique.

Method

Data was collected for all adult patients who underwent LA for appendicitis at a single institution over a 4-year period. Demographic data, complications, length of stay and hospital charges were compared between both groups.

Results

A total of 501 patients underwent LA in the 4-year period. There were no differences in age, gender or BMI. Additionally, there were no differences in procedure length, readmission rates, complication rates (including intra-abdominal abscess) or hospital charges. There was a slightly shorter length of stay in the endoloop closure group (1.22 days) vs endostapler (1.38 days), p = 0.002.

Conclusion

Neither technique of appendiceal stump closure demonstrated a unique advantage. These findings may have relevance in low resource environments that may not have routine access to surgical staplers. Closure of the appendiceal stump during a laparoscopic appendectomy can be done using multiple techniques.•The most common appendiceal stump closure techniques are the use of an endostapler or an endoloop.•There is no consensus on the “best” appendiceal closure technique.•There is no difference in outcomes between closure of the appendiceal stump with an endoloop versus an endostapler.

DOI

10.1016/j.amjsurg.2020.12.047

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