Experience with the use of tissue adhesives in pediatric endoscopic surgery

Background: Due to technological improvements, the use of tissue adhesives and glues for tissue approximation and hemostasis in surgery has increased. We report our preliminary experience with thistechnol ogy in pediatric endosurgery. Methods: Between 1997 and 2000, we employed tissue adhesives in 48 pediatric patients during laparoscopic procedures. In 25 patients, the glue was adopted for the hemostasis of parenchimal organs (liver in 24 cases and spleen in one). In three cases, the glue was used to repair organ perforation, in 19 it was used to close the distal part of a patent processus vaginalis in case of congenital inguinal hernia. In the final case, the glue was adopted to achieve optimal airtightness in case of pulmonary biopsy. The glue was injected with the aid of a needle positioned transparietally. Results: The procedure was easy and rapid in all cases, and there were no problemsor complications related to glue positioning at a mean follow up of 51 months. Conclusion: Tissue adhesives are a very versatile product for use in pediatric laparoscopic surgery. It is likely that their usage will increase as the technology improves and more effective productsare developed.