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Securing the Appendiceal Stump During Emergency Appendicectomy: Options and Influencing Factors in Current UK Surgical Practice

Wilson, Michael S.J., MBChB*; Knight, Stephen R., MBChB; Vaughan-Shaw, Peter, MBChB on behalf of the SCOTTISH SURGICAL RESEARCH GROUP

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: August 2018 - Volume 28 - Issue 4 - p 209–213
doi: 10.1097/SLE.0000000000000558
Original Articles

Introduction: The aim of our study was to identify the most commonly employed methods and influencing factors for securing the appendiceal stump in current NHS practice.

Methods: An electronic survey of the Scottish Surgical Research Group network, invitation extended to the UK National Research Collaborative.

Results: A total of 111 responses were received from 32 surgical centers; 28 (25.2%) consultants, 66 (59.5%) specialty trainees and 12 (10.8%) core trainees. Endoscopic ligatures were the preferred method in 96 (86.5%) with no difference in those with the greatest operative experience (P=0.79), 12 (10.8%) preferred polymeric clips. Ease of application (70.3%) and severity of stump inflammation (65.8%) had the greatest influence on the method chosen. Cost was a factor in 36.0%.

Conclusions: The preferred method for securing the appendiceal stump in UK practice is endoscopic ligatures regardless of operative experience. Factors with the greatest influence on the method employed include the ease of application and severity of stump inflammation. Our findings are likely to be representative of current NHS practice in Scotland.

*Department of General Surgery, NHS Tayside, Ninewells Hospital, Dundee

Department of General Surgery, Monklands Hospital, Airdrie

Department of General Surgery, Royal Victoria Hospital, Hayfield Road, Kirkcaldy, Scotland, UK

The following should also be credited as collaborative authors: Nicholas Ventham, David Mansouri, Rosalyn Shearer, Natalie Blencowe, Rhiannon Harries, Richard Wilkin, Shafaque Shaikh, Lawrence Adams, Ibrahim Ibrahim, Islam Noaman, Guo Liang Yong, Maria Coats, Kirit Singh.

The authors declare no conflicts of interest.

Reprints: Michael S.J. Wilson, MBChB, Department of General Surgery, Ninewells Hospital, Ninewells Avenue, Dundee DD1 9SY, Scotland, UK (e-mail:

Received January 12, 2018

Accepted May 21, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.