title: Tissue reaction to absorbable endoloop, nonabsorbable titanium staples, and polymer Hem-o-lok clip after laparoscopic appendectomy.
abstract: OBJECTIVE
  The standard technique for securing the base of the appendix during laparoscopic appendectomy is by absorbable endoloop ligature, although clinical reports favor the use of the stapler. Nonabsorbable Hem-o-lok clips have been shown to be an alternative technique to this. However, it is currently not clear whether nonabsorbable clips have any effects on the intestine or promote infection in the surgical area.
  
  
  METHODS
  Sixty Wistar albino rats were randomized into 3 treatment groups: group I (n=20) the base of the appendix was secured by endoloop 2-0 ligature; group II (n=20) dissection of the appendix was performed by a 45-mm thick stapler; and group III (n=20) the base of the appendix was secured by a Hem-o-lok plastic clip. The animals were sacrificed on the 14th and 28th days after surgery. The secured stump was used for histopathological examination.
  
  
  RESULTS
  There were no significant differences in histopathological changes observed on the 14th postoperative day between the groups. On the 28th postoperative day, it was proved that mild and moderate inflammation is more frequent in the endoloop and Hem-o-lok groups than in the stapler group. Reaction to a foreign body is more frequent in the endoloop than in stapler and Hem-o-lok groups.
  
  
  CONCLUSIONS
  The mildest postoperative inflammatory changes were seen in the stapler group, followed by the Hem-o-lok group. However, because of the price of the plastic clip and the simplicity of its application, its use is still favored during laparoscopic appendectomy.
authors: Department of Surgery, University Clinic Center Tuzla, Bosnia and Herzegovina. delibegovic.samir@gmail.com
authors: Samir
authors: S
authors: Delibegović
authors: Ermina
authors: E
authors: Iljazović
authors: Muhamed
authors: M
authors: Katica
authors: Anhel
authors: A
authors: Koluh
mesh_terms: D000818:Animals; D001062:Appendectomy / Q000295:instrumentation* / Q000379:methods; D002432:Cecum / Q000473:pathology; D005549:Foreign-Body Reaction / Q000453:epidemiology* / Q000473:pathology; D006097:Granulation Tissue / Q000473:pathology; D010535:Laparoscopy; D011108:Polymers; D051381:Rats; D017208:Rats, Wistar; D017792:Surgical Stapling; D013536:Suture Techniques / Q000295:instrumentation
chemical_list: D011108:Polymers