Laparoscopic appendectomy: Hem-o-lok versus Endoloop in stump closure

Abstract

There are several techniques described to close the appendicular stump during laparoscopic appendectomy. The aim of this study was to investigate the safety and usefulness of the Hem-o-lok clip for the closure of appendicular stump, comparing these data with those concerning the endo-loop. We conducted a retrospective study that compared two groups of patients who underwent laparoscopic appendectomy from 2010 to 2015 at our institution. We used the Endoloop to close the stump in the first group (group I) and the Hem-o-lok in the second group (group II). We reviewed patient's data including: complications, operative time, length of stay, costs. There were 121 patients in group I and 138 patients in group II. The mean operative times were 40.5 min in group I and 36.4 min in the group II. No intraoperative complications and no mortality were observed in either group. The mean postoperative length of hospital stay was similar for both groups. There was no rehospitalization after discharge. The complication rate did not reach statistical significance between the groups. The cost of the procedure using the Hem-o-lok has been lower than using the Endoloop. Both the Endoloop and Hem-o-lok are safe for the closure of the appendicular stump. Hem-o-lok appears to be superior than Endoloop in terms of easeness of use and cheapness, maintaining the same safety.

Hem-o-lok clip versus hand-made loop in base closure during laparoscopic appendectomy in children

“…The current study reveals significant shorter operative time in favor of hem-o-lok clip group, and this could be due to the simplicity of its application even by a first-time user. Similar results were observed in other studies which depended on polymer clip in comparison to the use of endoloop [19,21,22], whereas Colak et al has reported that mean operative time was shorter in hem-o-lok clip group than endoloop group, however, the difference was not significant [20].…”

“…Hem-o-lok clip is a non-absorbable polymer clip and the safety of its use for ureters and vessels clipping has been obviously declared in previous studies [17,18]. The comparison between hem-o-lok clip and endoloop for appendicular base closure has been documented in several studies in adult and pediatric patients [19][20][21][22], while the comparison between polymer clip and hand-made loop has still not been documented.…”

Comparison of methods for closure of appendix stump during laparoscopic appendectomy using endoloops: Single surgeon experience

“…The duration of operation, however, was shorter in endoloop patients. In their study comparing single proximal endoloop and Hem-o-lock clips, Lucchi et al [12] found that patients in both groups experienced a similar length of hospital stay and the rate of infectious complications. Bali et al [16] compared the use of double intracorporeal knots and endoloops and found that the duration of operation was higher when the intracorporeal knot was used, but there was no difference in the rate of complications.…”

“…Çelik et al Comparison of methods for closure of appendix stump during laparoscopic appendectomy using endoloops Beldi et al [7] Single endoloop Safavi et al [14] Endoclips Lucchi et al [12] Single endoloop In a study of 208 patients by Beldi et al, [7] a single endoloop was used in 109 patients, while double endoloop was used in the remaining 99 patients. Post-operative complications occurred in five patients (4.6%) in the single endoloop group and in five patients (5.1%) in the double endoloop group.…”

“…Ulus Travma Acil Cerrahi Derg 2019;25:616-621. [10][11][12][13][14][15] However, publications comparing the double endoloop or intracorporeal knot method with a single endoloop or intracorporeal knot method are scarce. [6] In our study, we aimed to retrospectively assess the results for the patients in our clinic who underwent a laparoscopic appendectomy using a single or double endoloop, with reference to the literature.…”