Eur J Pediatr Surg 2012; 22(02): 133-135
DOI: 10.1055/s-0032-1308693
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Closing the Appendicular Stump with a Polymeric Clip in Laparoscopic Appendectomy: Analysis of 121 Pediatric Patients

İbrahim Akkoyun
1   Department of Pediatric Surgery, Dr.Faruk Sükan Maternity and Children Hospital, Konya, Turkey
,
Fatih Akbıyık
2   Department of Pediatric Surgery, Dıskapi Children Hospital, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

17 August 2011

21 October 2011

Publication Date:
19 April 2012 (online)

Abstract

Introduction The purpose of this study was to evaluate the technical feasibility and other advantages of closing the appendicular stump with a polymeric clip in laparoscopic appendectomy (LA).

Methods In this study, 121 pediatric patients who underwent LA between July 2009 and July 2011 were included. Age and gender of the patients, the number of clips, operative time and length of hospitalization, complications, and follow-up periods were evaluated retrospectively.

Results Of appendicular stump of a total of 121 patients who were underwent LA, 71 were closed with double polymeric clips and 50 were closed with a single polymeric clip. Patients were between the ages of 3 and 15 years (mean 8.3 years). Out of the 121 patients, 54 were female and 67 were male. The duration of the operation was ranged from 13 to 55 minutes (mean 28 minutes). Of these, 83 patients were discharged in less than 24 hours. The cost of a single clip was 10 USD. The follow-up period of patients were ranged between 1 and 23 months (mean 13 months). No operative or postoperative complications occurred depending on the application of the polymeric clip.

Conclusion LA using polymeric clip/s to close appendicular stump in children is a safe, feasible, and inexpensive method.

 
  • References

  • 1 Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990; 132 (5) 910-925
  • 2 Ikeda H, Ishimaru Y, Takayasu H, Okamura K, Kisaki Y, Fujino J. Laparoscopic versus open appendectomy in children with uncomplicated and complicated appendicitis. J Pediatr Surg 2004; 39 (11) 1680-1685
  • 3 Beldi G, Muggli K, Helbling C, Schlumpf R. Laparoscopic appendectomy using endoloops: a prospective, randomized clinical trial. Surg Endosc 2004; 18 (5) 749-750
  • 4 Klaiber C, Wagner M, Metzger A. Various stapling techniques in laparoscopic appendectomy: 40 consecutive cases. Surg Laparosc Endosc 1994; 4 (3) 205-209
  • 5 Ping H, Xing NZ, Zhang JH, Yan Y, Kang N, Niu YN. Application of the Hem-o-lok ligation system in laparoscopic nephrectomy. Surg Endosc 2010; 24 (6) 1494-1497
  • 6 Delibegović S, Matović E. Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy. Surg Endosc 2009; 23 (12) 2851-2854
  • 7 Mora ER, Galí OB, Garin JA, Arango O. Intravesical migration and spontaneous expulsion of a Hem-o-lok polymer ligating clip after laparoscopic radical prostatectomy. Urology 2010; 75 (6) 1317
  • 8 Lucchi M, Duranti L, Melfi F, Mussi A. Polymer self-locking clips for vascular control during minimally invasive pulmonary lobectomies. J Thorac Cardiovasc Surg 2010; 139 (5) 1345-1346
  • 9 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) 1077-1082
  • 10 Dekel Y, Mor E. Hem-o-lok clip dislodgment causing death of the donor after laparoscopic living donor nephrectomy. Transplantation 2008; 86 (6) 887