Laparoscopic stapler appendectomy

Wagner, Markus; Aronsky, Dominik; Tschudi, J.; Metzger, A.; Klaiber, C

doi:10.1007/bf00188478

Cited by 34 publications

(9 citation statements)

References 11 publications

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“…The use of endoscopic linear staplers to control the appendix base is the most common technique and has been shown to be safe and effective. 12 , 13 However, there is a significant cost associated with this application; stapler handles and loads usually cost several hundred dollars. Institution-specific pricing schedules prevent detailed comparison of stapler/load costs, but there is no question that polymeric clips are much less expensive than endoscopic staplers.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Polymeric Clips for Appendiceal Stump Closure

Reinke

Tabone

Fong

et al. 2016

JSLS

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Background and Objectives:Laparoscopic appendectomy remains one of the most common emergency general surgical procedures in the United States. In an era of increasing focus on costs in medical care, we sought to evaluate the use of polymeric clips to secure the appendiceal base during laparoscopic appendectomy.Methods:We performed a prospective cohort study of patients undergoing laparoscopic appendectomy from April 2013 through September 2014 at a single academic teaching institution. Polymeric clips were used to secure the appendiceal stump. Tissue dissection techniques and control of the mesoappendix were the operating surgeon's choice. Clinical outcomes are reported.Results:A total of 25 patients (56% women; mean age, 41 y; body mass index of 29 kg/m2) were enrolled in our study and underwent laparoscopic appendectomy with polymeric clips. One patient was unable to have polymeric clips placed due to inflammation of the appendiceal base. There were no major perioperative complications. One patient developed a suture abscess in the umbilical incision, and another had prolonged ileus with computed tomography demonstrating persistent pelvic fluid that did not require intervention. Median length of stay was 1 d and mean length of follow-up was 81 d. The use of polymeric clips contributed ∼ $32 to the overall operative cost.Conclusions:Polymeric clips are a safe alternative for securing the appendiceal base in laparoscopic appendectomy. They offer significant cost savings without any evidence of increased complications.

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Polymeric Clips for Appendiceal Stump Closure

Reinke

Tabone

Fong

et al. 2016

JSLS

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“…Most surgeons have either used a stapler or endoloop to close the appendicular stump [2,10,11]. Recently, some studies have reported the safety of using the Hem-o-lok clip for the closure of appendicular stump [6-9].…”

Section: Discussionmentioning

confidence: 99%

The usefulness and safety of Hem-o-lok clips for the closure of appendicular stump during laparoscopic appendectomy

Hue

Kim

et al. 2013

J Korean Surg Soc

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PurposeThe purpose of this study was to investigate the safety and usefulness of the Hem-o-lok clip for the closure of appendicular stumps and limitations of the Hem-o-lok clip.MethodsFrom May 2010 to August 2011, 105 consecutive patients underwent laparoscopic appendectomies by three surgeons. XL size Hem-o-lok clips were used for the closure of appendicular stumps by one surgeon. The remaining surgeons used double endoloop ligatures. Prospectively collected data from patients who underwent laparoscopic appendectomy due to acute appendicitis were retrospectively reviewed.ResultsA total of 105 laparoscopic appendectomies were performed. The endoloop group consisted of 66 patients (mean age, 34.6 years; range, 16 to 82 years), while the Hem-o-lok group consisted of 39 patients (mean age, 43.5 years; range, 11 to 88 years). In three cases, the Hem-o-lok clip was not used due to enlargement and severe inflammation of the appendix base. No specific intraoperative or postoperative complications were observed in either group.ConclusionThe use of Hem-o-lok clips for the closure of appendicular stumps in laparoscopic appendectomy is a feasible, safe, fast and cost-effective procedure in patients with a mildly to moderately inflamed appendix base of less than 10 mm in diameter.

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“…Although diagnostic laparoscopy in the setting of suspected acute appendicitis provides increased diagnostic accuracy, it does not prevent missed appendicitis [12]. Concern exists about the ability to reliably detect abnormal pathologic findings in the appendix during operation.…”

Section: Discussionmentioning

confidence: 99%