Endostapler versus Hem-O-Lok clip to secure the appendiceal stump and mesoappendix during laparoscopic appendectomy

Al-Temimi, Mohammed; Berglin, Mendy A.; Kim, Edwin G.; Tessier, Deron J.; Johna, Samir

doi:10.1016/j.amjsurg.2017.08.031

Cited by 18 publications

(22 citation statements)

References 16 publications

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“…In the study by Al-Termini et al, HOL clip use was associated with lower overall complications rate compared with endoloops. The minimum endoloop cost per single appendectomy was $273.13, while HOL clip cost was $32.14 [167].…”

Section: Q47: Does Aspiration Alone Confer Clinical Advantages Overmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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Section: Q47: Does Aspiration Alone Confer Clinical Advantages Overmentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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“…In the studies where stump closure materials were compared, no difference was found between use of endoloop, suture, endostapler, and endoclip in terms of postoperative morbidity and intra-abdominal abscess development (28)(29)(30)(31) . In this study, although the postoperative morbidity rate was higher when the closure of the stump was performed with sutures, it was found to be insignificant as a risk factor on morbidity in multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Affecting Postoperative Morbidity in Laparoscopic Treatment of Perforated Appendicitis, a Single Center Experience

Sürek¹,

Karabulut²

2020

BMJ

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Objective: Postoperative morbidity may occur more in laparoscopic treatment of perforated appendicitis than simple appendicitis. In this study, we aimed to investigate the risk factors affecting the development of morbidity in laparoscopic treatment of perforated appendicitis. Method: The files of patients who underwent laparoscopic appendectomy due to perforated appendicitis were analysed retrospectively. Finding of perforation has been documented by surgeons who performed surgery. Information on the patients such as age, gender, Charlson Comorbidity Index (CCI), body mass index (BMI), ASA scores, symptom onset time, time between hospital admission and surgery, surgical findings, perforation sites, type of surgery, stump closure materials, white blood cell counts, pathology results and postoperative morbidities were recorded. Data were compared between patients with and without morbidity, and multivariate regression analysis of variables with significant p value was performed. Results: The rate of morbidity development in laparoscopic treatment of perforated appendicitis was 22.14% (66/298). In multivariate regression analysis, the onset of symptoms longer than 72 hours, proximal perforation, grade 5 diffuse peritonitis in surgical finding according to Disease Severity Score (DSS), conversion from laparoscopic to open surgery and gangrene or necrosis in histopathological finding were found to be effective risk factors in the development of morbidity.

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“…15,16 Improper closure of the appendix stump is an important step during appendectomy as it may cause serious postoperative complications. Endostapler, 7,10,17,18 endo ligature (endoloop), 7,8,18 metal endoclips, 2,11,19,20,21 bipolar endocoagulation, polymeric endoclips (hem-o-log clip) 9,10,22 and intracorporeal suture 2,3,23 are used for the closure of the appendix stump in LA. 24 Complications of appendicitis are very important in patients with CA.…”

Section: Discussionmentioning

confidence: 99%

“…Endoloop, endostapler, metal endoclip, Hem-O-Lok clip and intracorporeal ligation were used to close the appendiceal stumps. 2,7,8,9,10,11 Complicated appendicitis (CA) means a gangrenous and/or perforated appendix that can lead to abscess formation and peritonitis. The laparoscopic grading system (LGS) of acute appendicitis (AA) was first described by Gomes et al 12 It should be kept in mind that appendix base necrosis, which is the most common reason for procedure failure in some patients, is the most important factor in the closure of the appendix in most studies.…”

Section: Introductionmentioning

confidence: 99%

“…The laparoscopic grading system (LGS) of acute appendicitis (AA) was first described by Gomes et al 12 It should be kept in mind that appendix base necrosis, which is the most common reason for procedure failure in some patients, is the most important factor in the closure of the appendix in most studies. 9,10,11 The most common complications after LA are of infectious origin, especially postoperative intraabdominal abscess (POIAA) formation. It has been emphasized that appendiceal stump leakage may be an important factor in POIAA formation.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Laparoscopic Embedding Technique and Other Techniques for Appendiceal Stump Closure

Güneş¹,

Gemici²,

Dönmez³

2019

tjcd

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Amaç: Akut apandisit tüm dünyada en sık görülen cerrahi acil durumdur. Laparoskopik apendektomi akut apandisit ameliyatlarında yaygın olarak kullanılmaktadır. Apendiks güdüğünün kapatılmasında birçok teknik kullanılmıştır. Çalışmamızda, laparoskopik gömme tekniğinin etkinlik ve güvenilirliğini araştırmayı amaçladık. Yöntem: Temmuz 2017-Aralık 2018 tarihleri arasında akut apandisit için apendiks güdüğünün kapatılmasında laparoskopik gömme yöntemi kullanılan hastalar dahil edildi. Fizik muayene, laboratuvar testleri, ultrason ve bilgisayarlı tomografi muayenesi ile akut apandisit tanısı kondu. Mezoapendiksin diseksiyonu bir LigaSure cihazı ile yapıldı ve daha sonra apendiks radiks intrakorporeal düğümleme tekniği ile bağlandı ve bir keseli dikiş ipliği ile çekuma ters çevrildi. Hastalar yaş, cinsiyet, vücut kitle indeksi (VKİ), dönüşüm oranı, ameliyat süresi, ameliyat sonrası komplikasyonlar ve hastanede kalış süresi açısından incelendi. Bulgular: Yaş ortalaması 34,81±1,88 idi; ortalama VKİ 27,51±5,44 kg/m 2 idi. Ortalama ameliyat süresi 61,93±17,67 dk idi. Otuz iki hastada komplike apandisit, 39 hastada komplike olmayan apandisit vardı. Komplike olmayan apandisitli hastalarda, 4 hastada cerrahi alan enfeksiyonu ve 2 hastada ileus gelişti; komplike apandisit olgularında 2 hastada ileus, 3 hastada cerrahi alan enfeksiyonu gelişti. Ortalama hastanede kalış süresi 38,92±25,90 saat idi. Sonuç: Laparoskopik gömme tekniği akut apandisit için kolay, basit, güvenli, hızlı ve etkilidir ve komplike apandisitte appendiks tabanının güvenliğinde tercih edilen yöntem olacaktır. Anahtar Kelimeler: Laparoskopik apendektomi, akut apandisit, apendiks güdüğü Aim: Acute appendicitis is the most common surgical emergency worldwide. Laparoscopic appendectomyis widely used in acute appendicitis. In our study, we aimed to investigate the efficacy and safety of laparoscopic embedding technique. Method: Patients who underwent laparoscopic embedding technique for appendiceal stump between July 2017 and December 2018 were included in the study. Acute appendicitis was diagnosed by physical examination, laboratory tests, ultrasound and computed tomography scan. Dissection of the mesoappendix was performed with a bipolar tissue sealing system, and then the appendix radix was ligated using intracorporeal knotting technique and inverted into the cecum with a suture. The patients were evaluated in terms of age, gender, body mass index (BMI), rate of conversion, operative time, postoperative complications and length of hospital stay. Results: The mean age was 34.81±1.88 years and the mean BMI was 27.51±5.44 kg/m 2. The mean operative time was 61.93±17.67 minutes. Thirtytwo patients had complicated appendicitis and 39 patients had uncomplicated appendicitis. In patients with uncomplicated appendicitis, four patients developed surgical site infection and two patients had ileus; whereas two patients developed ileus and three patients developed surgical site infection in complicated appendicitis cases. The mean length of hospital stay was 38.92±25.90 ho...

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Endostapler versus Hem-O-Lok clip to secure the appendiceal stump and mesoappendix during laparoscopic appendectomy

Cited by 18 publications

References 16 publications

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Risk Factors Affecting Postoperative Morbidity in Laparoscopic Treatment of Perforated Appendicitis, a Single Center Experience

Comparison of Laparoscopic Embedding Technique and Other Techniques for Appendiceal Stump Closure

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