ANAHEIM, CA (UroToday.com) - The group from Loma Linda presented vascular complications during laparoscopic nephrectomy caused by automatic stapling devices (ASD), titanium clips (TC) and non-absorbable polymer ligating clips (NPL). This study was conducted via review of the FDA MAUDE database from 1992-2006 where 352 device failures were reported. 223 (63%) were from ASD including 3 deaths, 111 (33%) were from TC including one death, and 18 (5%) from NPL including 3 deaths. ASD failure most commonly resulted from staple line malformations (47%), and "locking up" (29%). TC failed because of jamming/feeding difficulties (27%) and "scissoring" of clips (26%). NPL malfunctions were rarely reported, but when they occurred, they were potentially severe with clips falling off the renal artery the most frequent (44%). They concluded all surgical devices used to secure the renal hilum may malfunction with potentially life-threatening complications and that knowledge of the mechanisms of failure can be used to prevent complications during laparoscopic surgery.

( ABSTR [1232] )

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