Vereinfachte Appendektomie ohne Stumpfversenkung Erfahrungen aus 20 jähriger konventioneller und 5 jähriger laparoskopischer Anwendung

Abstract

Since 1975, the Department of Surgery in the Grevenbroich Community Hospital (Germany) has applied a simplified technique of open appendectomy. The inhouse modified procedure without stump embedding has been performed in 3,448 cases to date. The same approach has been used in 1,463 laparoscopic appendectomies since 1991. In the laparoscopic procedure the stump is ligated solely with Roeder's loop. None of the 4,911 patients who have undergone either open or laparoscopic appendectomy have developed stump inadequacy or stercoral fistulae. According to the special literature, the complication rate after appendectomies without stump embedding is lower than that after standard procedures. In retrospect, laparoscopic appendectomy with simple ligation has confirmed the results achieved with simple ligation in open appendectomies. The technique should therefore become more common practice in open appendectomies, as well.

Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling?

“…In the early days of LA, the stump was closed with preknotted loops (Roeder loops or endoloops) [1,8,26]. After the introduction of laparoscopic linear staplers, it became ''en vogue'' to apply these in LA, particularly for difficult cases such as perforation at the appendiceal base [4,5,11].…”