Method for appendix stump closure during laparoscopic appendectomy (literature review)

Abstract

Currently, the laparoscopic appendectomy is the preferred method for treatment of acute appendicitis. Laparoscopic approach resulted in a decrease of postoperative morbidity (especially for reducing the frequency of surgical site infection), allows to faster postoperative recovery of patients. The method of closure of the appendix stump is the main step of laparoscopic appendectomy. The risk of intra-abdominal complications is considered high during this step. Therefore, it is important to choose the safest method of closure of the appendix stump among the number of available options. The four prominent management options are endoloops, staplers, endoclips and inversion of appendix stump with intracorporal sutures. This literature review presents the advantages and disadvantages of these methods. The results of randomized studies and meta-analysis comparing the methods are also presented. It is shown that there is no evidence pointing to any of the existing methods to be a safer option. It is suggested that factors such as anatomy features, cost efficiency and personal experience of the surgeon using these methods are considered to determine the choice.