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

Abstract

To evaluate the efficacy and safety of hem-o-lok clip in base closure during laparoscopic appendectomy (LA) in children and compare its outcomes with hand-made loop. A prospective study was performed that included all patients who underwent LA at our hospital from January 2017 to March 2018. The cases were randomly divided into two groups according to the method used for base closure; in the first group double hem-o-lok clips were used, while double hand-made loops were adopted in the second group. Data were collected and compared between groups by t and Chi-square tests including clinical data, operative time, complications, hospital stay and cost of supplies. The study included 44 patients, hem-o-lok clip group and hand-made loop group consisted of 21 and 23 patients, respectively. There were no significant differences between both groups concerning patients’ demographics, complications or hospital stay. Mean operative time was 29.95 ± 8.33 min in hem-o-lok clip group (range 18–47), whereas it was 38.78 ± 4.91 min in hand-made loop group (range 31–52) reaching statistical significance (p = 0.001). In terms of costs, a cartridge of hem-o-lok clips to be used per each case costs approximately 14 USD in our country, while a single package of Vicryl ligature 2-0 for forming hand-made loops costs 4 USD. Hem-o-lok clip is effective and safe in securing the base of appendix during LA in children. Although it is slightly more expensive than hand-made loop, it offers a significantly shorter operative time as the principal advantage when compared to hand-made loop which is superior because of its economic value.