Laparoscopic repair for perforated peptic ulcers with U-CLIP®

BACKGROUND The literature established that, in patients without Boey's risk factors, laparoscopic repair of perforated peptic ulcers, compared to open repair, is associated to lower wound infection rate, less analgesic use, reduction in post operative pain, shorter hospital stay. Some of the main drawbacks are length of operative time and laparoscopic surgeon's experience in intracorporeal knotting.We, for first, report our preliminary experience of perforated peptic ulcers' laparoscopic repair using Medtronic U-Clip(R). METHODS From January 2008 to June 2008 we performed laparoscopic repair of perforated peptic ulcers using Medtronic U-Clip(R) in 10 consecutive patients (6 men and 4 women, from 20 to 65 years-old of age). All the patients presented with iuxtapyloric perforated peptic ulcer, not greater than 10 mm, without signs of sepsis, free from major illnesses. The mini-invasive procedure was performed both by skilled and non-skilled laparoscopic surgeons under experts' surveillance. After it was recognized, perforation was sutured using U-Clip(R) in a full-thickness manner. RESULTS AND DISCUSSION We reported no surgical complications in the peri-operative period. The clinical outcome and time needed to perform the intervention didn't change between skilled and non-skilled surgeons. The follow-up at 30 days was good. CONCLUSION In our experience, the anastomotic device U-Clip(R) simplifies laparoscopic repair of perforated peptic ulcer, avoiding the need to perform knots and making the procedure safe and easier.