Hem-o-lok plastic clips in securing of the base of the appendix during laparoscopic appendectomy.
BACKGROUND
During laparoscopic appendectomy (LA), the standard technique in securing of the base of the appendix is by endoloop ligatures. However, application of the endoloop demands dexterity and a short training, while hem-o-lok clips may be more advantageous to use due to their simplicity of application and low cost. The objective of this study was to evaluate the technical feasibility and eventual advantages of this way of securing of the base of the appendix.


METHODS
Prospective study was conducted in the period from August 2006 to August 2008. The patients were divided into two groups; in the first group the base of the appendix was secured by double endoloop ligatures, while in the second group it was done by double nonabsorbable hem-o-lok clips. The data collected included age, gender, operative time, hospital stay, costs, and intra- and postoperative complications.


RESULTS
There was no difference in hospital stay between the two groups of patients; mean operative time was 47.1 ± 6.7 min in the first group where the base was secured by endoloop ligatures, and was 38.7 ± 5.0 min in the group where the base was secured by hem-o-lok clips. The cost of the three hem-o-lok clips was <euro>76.9, and that of the three endoloop ligatures was <euro>88.5. In hem-o-lok group of patients, one intraoperative complication was observed, involving bleeding of mesoappendix. There were no postoperative complications in either group of patients.


CONCLUSIONS
The simplicity of application, shorter time of operation, and lower cost of hem-o-lok clips are advantages of this way of securing of the base of the appendix in relation to the standard endoloop procedure.
Department of Surgery, University Clinic Center, Tuzla, Bosnia and Herzegovina. delibegovic.samir@gmail.com
Samir
S
Delibegović
Ervin
E
Matović
D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000295:instrumentation*; D001064:Appendicitis / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy / Q000295:instrumentation*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments; D055815:Young Adult