IMPORTANCE OF STUMP-TREATMENT IN LAPAROSCOPIC APPENDECTOMY

In laparoscopic appendectomy several variants of technique have been p roposed. In a randomized prospective trial we compared three common te chniques: 1. application of two endoloops, 2. application of two endol oops and additional manual stump sinking 3. application of endo-cutter . The study included 150 patients, 50 each per technique. The applicat ion of two endoloops with additional manual stump sinking as well as t he cutter technique were associated with a low risk for complications. In contrast, appendectomy by two endoloops without stump sinking was associated with a higher risk for local complications. The manual stum p sinking requires a high level of manual experience, whereas the cutt er technique can be learned rapidly by surgical residents. Therefore, we recommend the cutter technique as standard procedure, because it al lows laparoscopic appendectomy to be performed with high reliability b y experienced surgeons as well as by novice surgical residents.