Comparison between catgut endoloop versus vicryl endoloop in laparoscopic appendicular stump closure

Authors

  • Mrunal Mithari Department of General Surgery, Kasturba Medical College, Mangalore, Karnataka, India
  • Sadhan G. Department of General Surgery, Kasturba Medical College, Mangalore, Karnataka, India
  • Rupa Merlyn M. Department of General Surgery, Kasturba Medical College, Mangalore, Karnataka, India
  • Sriram Bhat M. Department of General Surgery, Kasturba Medical College, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252404

Keywords:

Laparoscopic appendectomy, Endoloop, Catgut, Vicryl, Appendicular stump closure, Surgical outcomes, Minimally invasive surgery, Post-operative complications

Abstract

Background: Laparoscopic appendectomy has become the standard of care for acute appendicitis, offering numerous advantages over open surgery. The closure of the appendicular stump remains a critical step in this procedure, with various techniques available. This study aimed to compare the efficacy and outcomes of catgut versus vicryl endoloops in appendicular stump closure.

Methods: A prospective observational study was conducted at tertiary care hospitals in Mangalore from March 2022 to March 2024. Thirty-five patients undergoing laparoscopic appendectomy were included and divided into catgut (n=18) and vicryl (n=17) endoloop groups. Parameters evaluated included operative time, hospital stay duration, post-operative complications, and follow-up outcomes.

Results: The mean operative duration was comparable between groups (catgut: 1.2±0.4 hours, vicryl: 1.4±0.6 hours, p>0.05). The catgut group demonstrated significantly shorter hospital stays (3.0±0.8 versus 4.1±0.8 days, p<0.05). Post-operative complications were similar between groups, with pain being the most common (catgut: 50%, vicryl: 41.2%). Early oral intake was achieved in 60% of patients by post-operative day one. Follow-up showed good recovery in 71.4% of patients, with no reported cases of stump appendicitis among those who completed follow-up.

Conclusions: Both catgut and vicryl endoloops demonstrate comparable safety and efficacy in laparoscopic appendicular stump closure. While catgut endoloops showed advantages in hospital stay duration, both methods proved reliable with similar complication rates. The choice between materials can be based on surgeon preference and institutional protocols without compromising patient outcomes.

Metrics

Metrics Loading ...

References

McBurney C. IV. The incision made in the abdominal wall in cases of appendicitis, with description of new method of operating. Ann Surg. 1894;20(1):38-43. DOI: https://doi.org/10.1097/00000658-189407000-00004

Semm K. Endoscopic appendectomy. Endoscopy 1983;15(2):59-64. DOI: https://doi.org/10.1055/s-2007-1021466

Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg. 2004;239(1):43-52. DOI: https://doi.org/10.1097/01.sla.0000103071.35986.c1

Aziz O, Athanasiou T, Tekkis PP, Purkayastha S, Haddow J, Malinovski V, et al. Laparoscopic versus open appendectomy in children: a meta-analysis. Ann Surg. 2006;243(1):17-27. DOI: https://doi.org/10.1097/01.sla.0000193602.74417.14

Wei B, Qi CL, Chen TF, Zheng ZH, Huang JL, Hu BG, et al. Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis. Surg Endosc. 2011;25(4):1199-208. DOI: https://doi.org/10.1007/s00464-010-1344-z

Rickert A, Bönninghoff R, Post S, Walz M, Runkel N, Kienle P. Appendix stump closure with titanium clips in laparoscopic appendectomy. Langenbecks Arch Surg. 2012;397(2):327-31. DOI: https://doi.org/10.1007/s00423-011-0869-5

Kehagias I, Karamanakos SN, Panagiotopoulos S, Panagopoulos K, Kalfarentzos F. Laparoscopic versus open appendectomy: which way to go? World J Gastroenterol. 2008;14(31):4904-14. DOI: https://doi.org/10.3748/wjg.14.4909

Tiwari MM, Reynoso JF, Tsang AW, Oleynikov D. Comparison of outcomes of laparoscopic and open appendectomy in management of uncomplicated and complicated appendicitis. Ann Surg. 2011;254(6):927-32. DOI: https://doi.org/10.1097/SLA.0b013e31822aa8ea

Strzalka M, Matyja M, Rembiasz K. Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump. World J Emerg Surg. 2016;11:4.

Delibegovic S, Matovic E. Hem-O-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg Endosc. 2009;23(12):2851-4. DOI: https://doi.org/10.1007/s00464-009-0493-4

Elshoura A, Hassan O, Saber S. Application of different methods for stump closure in laparoscopic appendectomy. Egypt J Surg. 2017;36:131-6. DOI: https://doi.org/10.4103/1110-1121.204526

Gomes CA, Nunes TA, Fonseca Chebli JM, Junior CS, Gomes CC. Laparoscopy grading system of acute appendicitis: new insight for future trials. Surg Laparosc Endosc Percutan Tech. 2012;22:463-6. DOI: https://doi.org/10.1097/SLE.0b013e318262edf1

Sadat-Safavi SA, Nasiri S, Shojaiefard A, Jafari M, Abdehgah AG, Notash Jr AY, et al. Comparison the effect of stump closure by endoclips versus endoloop on the duration of surgery and complications in patients under laparoscopic appendectomy: A randomized clinical trial. J Res Med Sci. 2016;21:87. DOI: https://doi.org/10.4103/1735-1995.192503

Hue CS, Kim JS, Kim KH, Nam S-H, Kim KW. The usefulness and safety of Hem-o-lok clips for the closure of appendicular stump during laparoscopic appendectomy. J Korean Surg Soc. 2013;84:27-32. DOI: https://doi.org/10.4174/jkss.2013.84.1.27

Öz B, Emek E, Akyüz M, Sözüer E, Arıkan T, Akcan A, et al. Laparoscopic appendectomy using hem-o-lok polymer clips: a single-center experience. Int Surg. 2017;102(7-8):334-9. DOI: https://doi.org/10.9738/INTSURG-D-14-00270.1

Sajid MS, Rimple J, Cheek E, Baig MK. Use of endo-GIAversus endo-loop for securing the appendicular stump in laparoscopic appendicectomy: a systematic review. Surg Laparosc Endosc Percutan Tech. 2009;19(1):11-5. DOI: https://doi.org/10.1097/SLE.0b013e31818a66ab

Khanna S, Khurana S, Vij S. No clip, no ligature laparoscopic appendectomy. Surg Laparosc Endosc Percutan Tech. 2004;14(4):201-3. DOI: https://doi.org/10.1097/01.sle.0000136657.27798.b8

Arcovedo R, Barrera H, Reyes HS. Securing the appendiceal stump with the Gea extracorporeal sliding knot during laparoscopic appendectomy is safe and economical. Surg Endosc. 2007;21(10):1764-7. DOI: https://doi.org/10.1007/s00464-007-9239-3

Partecke LI, Kessler W, von Bernstorff W, Diedrich S, Heidecke CD, Patrzyk M. Laparoscopic appendectomy using a single polymeric clip to close the appendicular stump. Langenbecks Arch Surg. 2010;395(8):1077-82. DOI: https://doi.org/10.1007/s00423-010-0671-9

Chand P, Singh G, Kahlon PS. Comparison of stump closure techniques of the base of the appendix in laparoscopic appendectomy. J Evol Med Dent Sci. 2017;6(72):5092-7. DOI: https://doi.org/10.14260/jemds/2017/1107

Kuehnel F, Marusch F, Koch A, Gastinger I. Retained loose linear cutter staples after laparoscopic appendectomy as the cause of mechanical small bowel obstruction. Int J Colorect Dis. 2007;22(6):717-8. DOI: https://doi.org/10.1007/s00384-005-0759-9

Banu KJ, Titus A. A study to evaluate the safety and cost effectiveness of preformed catgut endoloops and polyglactin 910 extracorporeal ligation in the management of appendicular stump closure in laparoscopic appendicectomy. Int Surg J 2020;7:813-7. DOI: https://doi.org/10.18203/2349-2902.isj20200828

Strzałka M, Matyja M, Rembiasz K. Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump. World J Emerg Surg. 2016;11:4. DOI: https://doi.org/10.1186/s13017-015-0060-3

Rickert A, Colin MK, Runkel N, Kuthe A, Köninger J, Jansen-Winkeln B, et al. The TICAP-study (titanium clips for appendicular stump closure): a prospective multicentre observational study on appendicular stump closure with an innovative titanium clip. BMC Surg. 2015;15:85. DOI: https://doi.org/10.1186/s12893-015-0068-3

Yildiz F, Terzi A, Coban S, Zeybek N, Uzunkoy A. The handmade endoloop technique. A simple and cheap technique for laparoscopic appendectomy. Saudi Med J. 2009;30:224-7.

Antoniou SA, Mavridis D, Hajibandeh S, Hajibandeh S, Antoniou GA, Gorter R, et al. Optimal stump management in laparoscopic appendectomy: a network meta-analysis by the Minimally Invasive Surgery Synthesis of Interventions and Outcomes Network. Surgery. 2017;162:994-1005. DOI: https://doi.org/10.1016/j.surg.2017.07.013

Şimşek O, Bilgin İA, Uludağ S, Dal F, Velidedeoğlu M, Sarıbeyoğlu K, et al. Comparison of endoloop and polymer locking clip in ligating appendiceal stump during laparoscopic appendectomy. Laparosc Endosc Surg Sci. 2017;24:5-8. DOI: https://doi.org/10.14744/less.2017.65375

Sarkar S, Bose B, Sil S. Comparative Study Between Use of Commercially Available Endoloop and Handmade Loop in Closure of Appendicular Stump in Laparoscopic Appendectomy. Int J Sci Res. 2020;9(7):1-2.

Downloads

Published

2025-07-30

How to Cite

Mithari, M., G., S., Merlyn M., R., & M., S. B. (2025). Comparison between catgut endoloop versus vicryl endoloop in laparoscopic appendicular stump closure. International Journal of Research in Medical Sciences, 13(8), 3342–3345. https://doi.org/10.18203/2320-6012.ijrms20252404

Issue

Section

Original Research Articles