Endostapler vs Endoloop closure of the appendiceal stump in laparoscopic appendectomy: Which has better outcomes?

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. (C) 2020 Published by Elsevier Inc.