Clip Closure of The Appendicular Stump: A Safe Alternative to Endoloops?”

Fatima Abbassi, Saeed Ahmed, Syed Ali Haider, Akram Rajput, Zahid Ali Memon, Summaya Saeed

  • Syed Ali Haider Department of Surgery, Dow Medical College & Dr. Ruth K. M. Pfau Civil Hospital Karachi



To compare the outcome of clip closure versus endoloop closure of appendicular stump.

Study design

Randomized controlled trial.

Place & Duration of study

Department of Surgery, Rawal Medical and Dental Hospital Islamabad & Dr. Ruth K.M. Pfau Civil Hospital Karachi, from June 2016 to December 2017.


Patients of acute appendicitis undergoing laparoscopic appendectomy were enrolled and randomized into two groups. One group got closure of appendicular stump done with endoloops and the other group by titanium clips. Both groups were compared in terms of duration of surgery, mean hospital stay and postoperative complications.


A total of 70 patients were included and divided into groups of 35 patients each. Of the total 47% of the patients were males. Mean age was 26.2 years. Duration of surgery was 33.5 minutes in the endoloop group and 24.5 minute in the clip closure group which was statistically significant. (p=0.032). Duration of hospital stay was same for both the groups which was statistically insignificant (p>0.05). Postoperative complications were same in both groups (p>0.05).


Use of endoclips is a safe and effective alternative to endolopps. It is cost effective without increasing postoperative complications. The duration of hospital stay was same but there was significant decrease in the operating time in clip closure group.

Key words

Laparoscopic appendectomy, Appendicular stump, Clip closure, Endoloop.