Laparoscopic Appendectomy Using Hem-o-lok Polymer Clips: A Single-Center Experience

Abstract

Although the surgical technique of laparoscopic appendectomy (LA) stump has been well understood, there are many alternative techniques in relation to torocar positioning and closure of appendicular stump. In recent times, Hem-o-lok polymer clips (HOLP) was implemented in several studies in the closure of appendicular stump because of its lower cost and easy implementation. The purpose of this study to investigate the safety, usefulness, and cost effectiveness of HOLP for the closure appendecular stumps in LA. The study was carried out between December 2011 and December 2013. Patients with acute appendicitis were included in the study. Two groups were defined as patients with the HOLP and patients with endoloop. The prospectively collected data, including age, sex, body mass index, operative time, hospital stay, cost effectiveness, intraoperative, and postoperative complications were retrospectively analyzed. A total of 66 (35 male, 31 female) LA were performed. The endoloop group consisted of 30 patients (16 male, 14 female, and mean age, 30.4 ± 1.8), while the HOLP group consisted of 36 patients (19 male, 17 female, and mean age, 28.6 ± 1.6). The mean operative time was 42.5 ± 1.3 in the HOLP group and 53.8 ± 1.5 in the endoloop group (P < 0.0001). The mean hospital stay was 2.1 ± 0.2 days in HOLP group and 2 ± 0.2 in the endoloop group (P = 0.73). Both patient groups had no intraoperative complication, and no cases were converted to open procedure. Total hospital cost was 1170.8 ± 6.3 dollars in the HOLP group and 1094 ± 6.9 dollars in the endoloop group (P < 0.0001). The use of HOLP for the appendicular stumps in LA is a feasible, safe, and cost-effective procedure in patients with uncomplicated acute appendicitis.