外科ジャーナル

Review of Techniques in Occluding Appendicular Stump during Laparoscopic Appendectomy

Abstract

Venkateshen Palanisamy, Vinoth S, Rajan KV and Ramananthan M

Introduction: Laparoscopic appendectomy is the gold standard method of treatment of acute appendicitis. Closure of appendicular stump is the most important step to prevent complications. There are various methods to occlude the appendix. There is an insufficient analysis of the various methods to close the appendicular stump. The aim of this study was to analysis provide a treatment ranking of different options for securing the appendicular stump among endoloop, endostaplers, titanium clip, suture knots, Hem-o-Lok.

Methods: Online electronic databases were searched to find observation studies, review articles, randomized controlled trials comparing various methods ligation of the appendix. The primary outcomes were cost, availability, biocompatible, safety, learning curve.

Conclusion: The application of Hem-o-Lok for occluding the appendix in laparoscopic appendectomy seems to be superior to other methods but the final decision on the method to be used will depend on the surgeon’s experience and training with various techniques, the availability of equipment within the hospital, cost-effectiveness and the extent of appendix inflammation.