ArticleLangenbeck's archives of surgery2022
A new approach to laparoscopic appendectomy in children-clipless/sutureless Harmonic scalpel laparoscopic appendectomy.
Article in Langenbeck's archives of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Energy Devices for Clipless-Sutureless Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis on Utility and Safety.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Single-instrument intracorporeal ligation versus polymer clip closure of the appendiceal stump in laparoscopic appendectomy: a prospective randomized study.BMC surgery · 2026Trial
- Impact of Trocar Position on Surgical Site Infection After Pediatric Laparoscopic Appendectomy: A 15-Year Single-Center Study.Medical sciences (Basel, Switzerland) · 2026Article
- Effectiveness of different appendiceal stump closure methods in laparoscopic appendectomy in children: A systematic review and network meta-analysis.World journal of gastrointestinal surgery · 2025Article
- Salivary C-Reactive Protein: A Non-Invasive Alternative to Serum CRP in Pediatric Acute Appendicitis.Molecules (Basel, Switzerland) · 2025Article
- The Safety and Feasibility of Single-Stage Versus Staged Laparoscopic Approach for Acute Appendicitis with Inguinal Hernia in Pediatric Patients: A Comparative Study.Journal of clinical medicine · 2025Article
- Acute appendicitis induced by bone fragment ingestion: A pediatrics case report.Radiology case reports · 2024Article
- Management and Incidence ofJournal of clinical medicine · 2024Article
- Incidence and Management of Appendiceal Neuroendocrine Tumors in Pediatric Population: A Bicentric Experience with 6285 Appendectomies.Children (Basel, Switzerland) · 2023Article
- Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children.Children (Basel, Switzerland) · 2023Article
- Diagnostic Utility of Serum Leucine-Rich α-2-Glycoprotein 1 for Acute Appendicitis in Children.Journal of clinical medicine · 2023Article
- Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis.International journal of molecular sciences · 2023Article
- Self-Locking Polymeric Clips Are Safe for the Closure of Appendiceal Stump in Laparoscopic Appendectomy.Medicina (Kaunas, Lithuania) · 2023Article
- A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth.Children (Basel, Switzerland) · 2023Article
- Review
- Same-Day Discharge after Laparoscopic Appendectomy for Simple Appendicitis in Pediatric Patients-Is It Possible?Children (Basel, Switzerland) · 2022Article
- Hyponatremia-A New Diagnostic Marker for Complicated Acute Appendicitis in Children: A Systematic Review and Meta-Analysis.Children (Basel, Switzerland) · 2022Review
- Utility of Red Cell Distribution Width (RDW) as a Noninvasive Biomarker for the Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis of 5222 Cases.Diagnostics (Basel, Switzerland) · 2022Review
- Article
- Evaluation of the safety of using harmonic scalpel during laparoscopic cholecystectomy in children: A preliminary report.Frontiers in pediatrics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to investigate Harmonic scalpel performance in laparoscopic appendectomy for sealing the base of the appendix in children.
methodsDuring the study period, a total of 312 patients who underwent laparoscopic appendectomy were included in prospective bicenter clinical trial. The patients were divided in two study groups in regard to technique used for appendiceal base closure. In the first group (n = 197) the appendiceal base was secured using a polymeric clip while in the second group (n = 115) the Harmonic scalpel was used for sealing the base in a stepwise manner, without placing any clip or suture. Outcomes of treatment, including complication rates, duration of surgery and length of hospital stay were compared between the groups.
resultsA total of 312 patients with a median age of 11 years (IQR 8, 15) were included in study. Of these, 191 were males (61.2%). Both groups were symmetric in regard to baseline characteristics of the patients. A total of 10 (5.1%) postoperative complications (postoperative abscess n = 7 and ileus n = 3) were recorded in the polymeric clip group while none of the patients from the clipless group had postoperative complications (P = 0.015). In the group who received a polymeric clip appendectomy, fever lasting 0-72 h and > 72 h was recorded in 16 (8.1%) and 12 (6.1%) children, respectively, while in the clipless group, it was observed in 2 (1.7%) and 5 (4.3%) children, respectively (P = 0.048). Significantly shorter surgical times were found in the clipless group compared to the polymeric clip group (21 min (IQR 18, 25) vs. 30 min (IQR 22, 40), P < 0.0001). Also, length of hospital stay was significantly shorter in the clipless group of the patients (2 days (IQR 2, 3) vs. 3 days (IQR 2, 4), P < 0.0001).
conclusionClipless harmonic scalpel laparoscopic appendectomy is a safe and effective method in children for treatment of acute appendicitis with lesser number of complications and shorter duration of surgery compared to laparoscopic appendectomy in which the appendiceal base is secured with clip.
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Registered trials
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