Biomaterial Database

Management of the base of the appendix in pediatric laparoscopic appendectomy: clip, ligate, or staple? 2013

Monica Langer, and Arash Safavi, and Erik D Skarsgard

Tufts University Pediatric Surgeon Maine Medical Center Portland, Maine.

Options for intracorporeal appendiceal stump closure span a variety of techniques including ligation using intra-corporeal knots, extra-corporeal knots, or an endo-loop (EL), closure with endoscopic clips (EC), or endoscopic stapled (ES) closure. The guiding principles are the need for secure, inert closure of the appendiceal base without injury to the appendiceal stump or cecum, with minimal risks of complication attributable to the closure technique. Safety and complication rates, as well as cost data, should guide the techniques used for pediatric laparoscopic appendectomy. Based on the literature available there is not a clear answer as to the best method for closing the appendiceal stump in pediatric patients, with each of the methods described providing safe closure. Many institutions and surgeons may favor a selective approach, with choice of closure determined by the condition of the appendix at laparoscopy.

UI	MeSH Term	Description	Entries
D008026	Ligation	Application of a ligature to tie a vessel or strangulate a part.	Ligature,Ligations,Ligatures
D010535	Laparoscopy	A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.	Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D003362	Cost-Benefit Analysis	A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes.	Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001062	Appendectomy	Surgical removal of the vermiform appendix. (Dorland, 28th ed)	Appendectomies
D001064	Appendicitis	Acute inflammation of the APPENDIX. Acute appendicitis is classified as simple, gangrenous, or perforated.	Perforated Appendicitis,Ruptured Appendicitis,Appendicitis, Perforated,Appendicitis, Ruptured
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D013537	Sutures	Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed)	Staples, Surgical,Surgical Staples,Staple, Surgical,Surgical Staple,Suture
D015995	Prevalence	The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.	Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes