Polymeric clips are a quicker and cheaper alternative to endoscopic ligatures for securing the appendiceal stump during laparoscopic appendicectomy

M. S. J. Wilson (Lead / Corresponding author), P. Maniam, A. Ibrahim, N. Makaram, S. R. Knight, P. Patil

    Research output: Contribution to journalArticle

    7 Citations (Scopus)
    129 Downloads (Pure)

    Abstract

    Introduction: The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis.

    Materials and methods: Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015. Data collected included age, gender, body mass index, duration of surgery, length of hospital stay, antibiotic use, preoperative haematological and biochemical parameters, 30-day readmission rate and complications.

    Results: A total of 125 patients were included within the study, with 78 within the endoloop group and 47 in the polymeric clip group. There were no differences in age, gender, body mass index, hospital stay, antibiotic use, 30-day readmission rates or postoperative complications. Operative time was significantly reduced in the polymeric clip group (59 vs. 68 minutes, P = 0.00751). The use of polymeric clips cost £21 compared with £49 for endoloops per operation, which rose to £70 if both clips and endoloops were used during the procedure.

    Discussion: Polymeric clips are a safe, viable and economical method for securing the appendiceal stump during laparoscopic appendicectomy. The clinical significance of nine minutes of reduced operating time in the polymeric clip cohort warrants further study with an adequately powered randomised controlled trial.
    Original languageEnglish
    Pages (from-to)454-458
    Number of pages5
    JournalAnnals of the Royal College of Surgeons of England
    Volume100
    Issue number6
    Early online date15 Mar 2018
    DOIs
    Publication statusPublished - Jul 2018

    Keywords

    • Appendicitis
    • Laparoscopic appendicectomy
    • Polymeric clips
    • Endoscopic ligature
    • Endoloop
    • Humans
    • Middle Aged
    • Appendectomy/economics
    • Male
    • Length of Stay/economics
    • Appendicitis/economics
    • Operative Time
    • Young Adult
    • Hospital Costs/statistics & numerical data
    • Postoperative Complications/economics
    • Ligation
    • Aged, 80 and over
    • Adult
    • Female
    • Laparoscopy/economics
    • Retrospective Studies
    • Patient Readmission/statistics & numerical data
    • Child
    • Treatment Outcome
    • Adolescent
    • Aged

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