• Samir Delibegović and Ervin Matović.
• Department of Surgery, University Clinic Center, Tuzla, Bosnia and Herzegovina. delibegovic.samir@gmail.com
• Surg Endosc. 2009 Dec 1; 23 (12): 2851-4.

BackgroundDuring 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.Patients And MethodsProspective 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.ResultsThere 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 76.9, and that of the three endoloop ligatures was 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.ConclusionThe 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.

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