Response to Letter to the Editor
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KeywordsAppendicitis Abscess Formation Laparoscopic Appendectomy True Incidence Open Appendectomy
In our recent editorial “Stumped; the Achilles of Laparoscopic Appendectomy”, we speculated that burying the appendiceal stump in open appendectomy may be a key factor in mitigating the risk of intra-abdominal abscess formation postoperatively. It should be noted that in recent years with improvements in medical technology and increased availability of stapler devices, many surgeons use them, especially in complicated appendicitis cases. Additionally, many contemporary studies comparing surgical outcomes from laparoscopic appendectomy do not specifically mentioned whether simple Roeder knots or stapler devices have been used intra-operatively. This may mask the true incidence of intra-abdominal abscess rates in laparoscopic appendectomy with simple stump closure techniques.
Finally, the premise that our editorial suggested that open appendectomy was better that laparoscopic appendectomy is misconstrued. We highlighted that the burial of the appendiceal stump is the major difference between each approach and that the development of endoscopic devices to provide stump invagination should be worth considering, irrespective whether the approach is multi-port or single-port surgery.