Research Article

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

Volume: 17 Number: July, August, September 2026 August 27, 2026

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<0.001). The overall 30-day complication rate was 4.1% (n=15), with no significant difference among the groups (p=0.173). Late complications beyond 30 days occurred in three patients (0.8%): stump appendicitis in the clip group (n=1) and port-site hernia in the endostapler group (n=2). Conclusion: All three stump closure methods were safe and effective, with no significant difference in 30-day complicationrates. Rare late complications were observed and differed in nature between methods. The choice of closure method can be guided by surgeon preference, intraoperative findings, and cost considerations.

Keywords

Supporting Institution

No supporting institution

Ethical Statement

Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital Institutional Ethics Committee (Date: 14.05.2026, Decision No: E-46059653-050.04-314875725)

References

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  2. 2. Gomes CA, Sartelli M, Di Saverio S, et al. Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings. World J Emerg Surg. 2015;10:60. DOI:10.1186/s13017-015-0053-2
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  7. 7. Mayir B, Ensari CÖ, Bilecik T, et al. Methods for closure of appendix stump during laparoscopic appendectomy procedure. Turk J Surg. 2015;31:229-31. DOI:10.5152/UCD.2015.2768
  8. 8. Knight SR, Ibrahim A, Makaram N, et al. The use of polymeric clips in securing the appendiceal stump during laparoscopic appendicectomy: a systematic review. Eur J Trauma Emerg Surg. 2019;45:665-70. DOI:10.1007/s00068-019-01105-5

Details

Primary Language

English

Subjects

Surgery (Other)

Journal Section

Research Article

Publication Date

August 27, 2026

Submission Date

June 2, 2026

Acceptance Date

June 21, 2026

Published in Issue

Year 2026 Volume: 17 Number: July, August, September 2026

APA
Abdullah, S., Özkaya, G., Gündoğdu, A., Zenciroğlu, M., Figen, S., & Subaşı, İ. E. (2026). Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 17(July, August, September 2026). https://doi.org/10.31067/acusaglik.1961865
AMA
1.Abdullah S, Özkaya G, Gündoğdu A, Zenciroğlu M, Figen S, Subaşı İE. Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study. Acibadem Univ Saglik Bilim Derg. 2026;17(July, August, September 2026). doi:10.31067/acusaglik.1961865
Chicago
Abdullah, Sangar, Güney Özkaya, Adnan Gündoğdu, Mahmut Zenciroğlu, Safiye Figen, and İsmail Ege Subaşı. 2026. “Extracorporeal Loop, Hem-O-Lok Clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: A Retrospective Cohort Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 (July, August, September 2026). https://doi.org/10.31067/acusaglik.1961865.
EndNote
Abdullah S, Özkaya G, Gündoğdu A, Zenciroğlu M, Figen S, Subaşı İE (August 1, 2026) Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 July, August, September 2026
IEEE
[1]S. Abdullah, G. Özkaya, A. Gündoğdu, M. Zenciroğlu, S. Figen, and İ. E. Subaşı, “Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study”, Acibadem Univ Saglik Bilim Derg, vol. 17, no. July, August, September 2026, Aug. 2026, doi: 10.31067/acusaglik.1961865.
ISNAD
Abdullah, Sangar - Özkaya, Güney - Gündoğdu, Adnan - Zenciroğlu, Mahmut - Figen, Safiye - Subaşı, İsmail Ege. “Extracorporeal Loop, Hem-O-Lok Clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: A Retrospective Cohort Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17/July, August, September 2026 (August 1, 2026). https://doi.org/10.31067/acusaglik.1961865.
JAMA
1.Abdullah S, Özkaya G, Gündoğdu A, Zenciroğlu M, Figen S, Subaşı İE. Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study. Acibadem Univ Saglik Bilim Derg. 2026;17. doi:10.31067/acusaglik.1961865.
MLA
Abdullah, Sangar, et al. “Extracorporeal Loop, Hem-O-Lok Clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: A Retrospective Cohort Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol. 17, no. July, August, September 2026, Aug. 2026, doi:10.31067/acusaglik.1961865.
Vancouver
1.Sangar Abdullah, Güney Özkaya, Adnan Gündoğdu, Mahmut Zenciroğlu, Safiye Figen, İsmail Ege Subaşı. Extracorporeal loop, Hem-o-lok clip, and Endostapler for Appendiceal Stump Closure in Laparoscopic Appendectomy: a Retrospective Cohort Study. Acibadem Univ Saglik Bilim Derg. 2026 Aug. 1;17(July, August, September 2026). doi:10.31067/acusaglik.1961865