Surgical fasteners—including clips, staples, and sutures—are specialized medical devices used internally to assist the surgeon and facilitate the body’s natural healing process. They are purposefully placed to manage internal tissues and blood vessels. Their proven utility in securing internal structures before the natural healing response takes over is why they are used.
The Role of Internal Surgical Fasteners
Internal surgical fasteners perform two primary functions: achieving hemostasis and providing tissue approximation. Hemostasis is the process of stopping bleeding, which is accomplished by using clips to mechanically ligate, or tie off, blood vessels. By clamping the vessel, the clip provides an immediate, secure closure that withstands the pressure of blood flow.
Clips and staples also play a major role in tissue approximation, meaning holding the edges of internal tissues together. For example, specialized staplers are used during gastrointestinal surgery to quickly cut, seal, and rejoin sections of the bowel or stomach. This mechanical closure is essential for keeping the surgical site stable and protected immediately after the procedure. The presence of these fasteners minimizes trauma and shortens the operative time.
These internal devices are used on structures that cannot be easily or quickly sealed by traditional hand-sewn sutures, particularly in minimally invasive procedures. Clips allow the surgeon to rapidly and securely close off structures like the cystic duct or cystic artery during a gallbladder removal. This swift and precise mechanical action ensures the immediate integrity of the repaired or separated tissues.
Permanent Versus Temporary Materials
The answer to whether a clip is left in depends entirely on the material it is made from, as surgeons choose devices based on the required duration of support. Non-absorbable materials are designed to be permanent and remain in the body indefinitely. These are often made from inert metals, such as medical-grade titanium or stainless steel, which are highly biocompatible.
Titanium clips are frequently used to secure major blood vessels that require continuous, long-term occlusion to prevent bleeding. Once applied, the body does not react negatively to the titanium and simply encapsulates the tiny clip with a layer of fibrous scar tissue. This process securely anchors the clip, and its inert nature means it will not corrode inside the body.
In contrast, temporary devices are made from absorbable polymers, such as polyglycolic acid or polydioxanone, which are designed to dissolve. These materials provide the necessary mechanical support for a limited time, typically several weeks to a few months, until the tissue has healed sufficiently. After this period, the material is gradually broken down by the body’s metabolic processes and eliminated, leaving no foreign residue behind. The choice between permanent and temporary materials is a calculated surgical decision based on the size of the structure being secured and the expected healing time.
Safety and Long-Term Implications of Retained Clips
The long-term safety of retained surgical clips is well-established because the materials used are chosen specifically for their inert qualities. Modern permanent clips, particularly those made of titanium, are non-ferromagnetic, meaning they are not attracted to magnetic fields. This non-magnetic property makes them generally safe for patients undergoing magnetic resonance imaging (MRI) scans at standard field strengths. While they may create a small shadow or “artifact” on the resulting image, they will not move or cause significant heating.
The body’s typical reaction to these permanent, inert materials is a process known as encapsulation. The clip becomes surrounded by a thin layer of connective tissue, which effectively walls it off from the rest of the body. This protective barrier ensures the clip stays anchored in its original location and prevents any ongoing interaction with surrounding organs.
Concerns about clips moving, or migration, are understandable but rarely realized due to this encapsulation. Though extremely uncommon, a clip might need removal if it causes a rare complication, such as a localized infection or obstruction. Because titanium clips are radiopaque, meaning they show up clearly on imaging tests like X-rays and CT scans, a physician can easily monitor their precise location years after the original surgery. This visibility allows for quick verification of their presence and position during any necessary follow-up care.