Use of polymer clip in single site laparoscopic appendectomy

Fernando Arias, MD, Sofia Valanci, MD, Adolfo Torres, MD, Natalia Cortes

Fundacion Santa Fe de Bogota

There is a lot of controversy over the appendicular stump management in minimally invasive surgery. Techniques include mechanical suture, preformed knot and a polymer clip. The objective of this paper is to describe the management of the appendicular stump by single site laparoscopy surgery in our group.

Material and methods: All patients that required single site laparoscopic appendectomy between July 2008 to April 2012. Age, gender, appendicitis fase, operating time, hospital length of stay, use of drains and complications were evaluated.

Results: We had 181 patients. The average age was 34.7 years (18-90), 103 (56.9%) women and 78 (43.9%) men. 133 patients had non complicated appendicitis and 48 were complicated. Surgical time was 67.9 minutes (17-237), hospital stay 21.7 hours (2-386 h), drains were placed in 45 patients (24.8%). Two triport ® were used and 179 hybrids were manufactured with Alexis ® and a glove. As to stump management 18 mechanical sutures (Endo GIA ®) were used, 161 were managed with polymer clip (Hem-o-lok®), 2 with preformed knots. We had 5 surgical site infections, 4 patients had to be admitted to the hospital (2 for dehiscence, 2 for abdominal collections).

Conclusion: the use of the polymer clip is safe for the management of the appendicular stump, as shown in this study. It has the advantage of easy and fast use helping diminish surgical times, and furthermore it doesn’t need more learning curve than the average for single site appendectomy.

Session: Poster Presentation

Program Number: P485

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