ZenToks Publication

Chapter 19

Stump Closure Techniques for Laparoscopic Appendectomy in Acute Appendicitis: A Review

Abstract/Preface

Appendectomy is among the most frequently performed emergency surgical procedures globally. A pivotal aspect of laparoscopic appendectomy is the secure closure of the appendicular stump, which is essential to prevent postoperative complications such as stump leak, intra-abdominal abscess, and stump appendicitis. Over recent decades, various techniques for stump closure have been developed, ranging from simple ligature methods to advanced mechanical devices, including staplers, clips, and endo loops. Each technique presents unique advantages concerning safety, cost-effectiveness, operative time, and ease of use. The widespread adoption of minimally invasive surgery has introduced additional modalities in laparoscopic appendectomy, such as clips, energy devices, and intracorporeal suturing. This chapter seeks to critically assess the different appendicular stump closure techniques within the context of acute appendicitis, focusing on clinical outcomes, complication rates, and cost implications. Although no single technique is universally superior, current evidence indicates that secure closure, tailored to intraoperative findings and resource availability, remains crucial.