Safety and Efficacy of Polymeric Clips for Appendiceal Stump Closure.

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/m(2)) 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.