Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study

Abstract

Purpose: No consensus exists on the optimal method of appendiceal stump closure during laparoscopic appendectomy. This study aimed to compare the safety and clinical outcomes of three stump closure methods: loop, Hem-o-lok clip, andendostapler.Methods: Medical records of patients who underwent laparoscopic appendectomy for acute appendicitis between May 2023 and March 2025 at a single institution were retrospectively reviewed. Patients were grouped according to the stump closure method. Demographic data, operative parameters, histopathological findings, 30-day complications (Clavien-Dindo classification), and late complications were compared among the three groups.Results: A total of 368 patients were analyzed: loop (n=201), Hem-o-lok clip (n=100), and endostapler (n=67). The three groups were comparable in terms of demographics and comorbidities. The endostapler group had significantly larger appendix diameter on computed tomography and more intraoperative abscess findings (p