Endoloop Ligature Research Articles

Colecistectomia laparoscópica com ligadura endoloop em cadela com distúrbios biliares

A 4-year-old female poodle presented with eosinophilia and increased alanine aminotransferase during routine evaluation. Ultrasound examination revealed findings suggestive of mild liver steatosis, biliary mucocele, cholelithiasis, and cholecystitis, and conservative treatment was indicated. Thirty days later, the patient had diarrhea, abdominal pain, and weight loss. Laboratory examination revealed thrombocytopenia, hyperbilirubinemia, and increased activity of alkaline phosphatase and alanine transaminase. Based on the progressive changes in the exams and the condition suggestive of moderate to severe cholecystitis, a laparoscopic cholecystectomy with an endoloop ligature was performed. The dog recovered from surgery and anesthesia without complications and was discharged the next day. Amoxicillin with clavulanate, meloxicam, dipyrone, and tramadol hydrochloride were prescribed as a postoperative drug. The patient's recovery was quick and uneventful. Laparoscopic cholecystectomy was efficient in the treatment of bile duct disease of this bitch and the use of an endoloop was shown to be efficient for sealing the bile duct in this case.

The use of monopolar diathermy in laparoscopic appendectomy; Is it really safe?

BackgroundThere have been numerous techniques used in laparoscopic appendectomy (LA) to divide the mesoappendix, including LigaSure, Harmonic scalpel, clips, endoloop ligatures, Endo GIA staplers, and bipolar coagulation. However, few studies have investigated monopolar diathermy for mesoappendix division. Therefore, this study aimed to assess both its safety and efficacy in LA. MethodsIn this prospective non-randomized study, patients (n = 87) who underwent LA for acute appendicitis were included. The bipolar electrocautery was used for mesoappendix division in the first 33 patients (BC group), while the monopolar electrocautery was used in the next 54 patients (MC group). ResultsThe median operative time was significantly shorter in the MC group (42 min. vs 47 min. in BE group, p = 0.01). One patient converted to open surgery in the MC group due to uncontrollable bleeding. There were no significant differences between both groups regarding postoperative complications and hospital stay (p = 0.91, p = 0.13, respectively). ConclusionsMonopolar electrocautery is safe and effective for mesoappendix division in LP in comparison to bipolar electrocautery. However, larger and multicentric studies are required to validate our results.

Association between appendiceal stump closure method and post-operative bowel obstruction after laparoscopic appendectomy

BackgroundLaparoscopic appendectomy is one of the most common urgent pediatric surgical operations. Endoscopic surgical staplers and pre-tied endoloop ligatures are both routinely used for closure of the appendiceal stump in children. Practice patterns vary for a number of reasons, including cost, size, and ease of use. While stapling is standard for some pediatric surgeons, others believe that staples can act as a nidus for small bowel obstruction (SBO). However, studies comparing closure methods have been conflicting in their results and limited in size. Therefore, we aim to determine if there is an association between appendiceal stump closure method and SBO using a national comparative pediatric database. MethodsWe queried the Pediatric Health Information System (PHIS) for patients ages 3–18 years who underwent laparoscopic appendectomy for appendicitis between 1/1/2016 – 12/31/2020. We included hospitals that had greater than 50 patients with billing data and excluded patients with inflammatory bowel disease and simultaneous abdominal operations. We used billing data for the patient's appendectomy to determine if a stapler or a suture ligature was used during the case. Our primary outcome of interest was post-operative SBO or reoperation for lysis of adhesion or intestinal surgery within the first 30 post-operative days. Multivariable regression analyses were used to estimate the association between stump closure method and post-operative SBO or reoperation in addition to cost while adjusting for patient demographics and appendiceal perforation. ResultsIn total, 49,191 patients from 37 hospitals were included, of which, 29,733 (60.44%) were male, 21,403 (43.51%) were non-Hispanic white, and 18,291 (37.18%) had a diagnosis of complicated appendicitis. The median [IQR] age of the cohort was 11 [8–14] years. A surgical stapler was used during laparoscopic appendectomy in 35,788 (72.75%) patients, and early SBO or reoperation occurred in 653 (1.33%) patients. In adjusted analysis controlling for demographics and complicated appendicitis there was no statistically significant difference in the odds of SBO or reoperation between the two groups. (OR 1.17; 99% CI 0.86 – 1.6). Complicated appendicitis was the factor most associated with post-operative SBO or reoperation (OR 4.4; 99% CI 3.01 – 6.44). Median cumulative cost was slightly higher on unadjusted analysis in the stapler group ($10,329.3 vs $9,569.2). However, there was no significant difference on adjusted analysis. ConclusionSBO or reoperation following laparoscopic appendectomy for appendicitis is uncommon. Complicated appendicitis is the most predictive factor of this outcome. Adjusting for available patient, disease, and hospital characteristics, use of a surgical stapler does not appear to be meaningfully associated with the development of acute SBO or reoperation. Surgeon preference remains the mainstay for safe appendiceal stump closure method. Level of evidenceLevel III. Study typeRetrospective Comparative Study.

Ask your Surgeon: Appearance of Endoloops on Postoperative Imaging after Pediatric Appendectomy

Laparoscopic appendectomies in children require closure of the appendiceal stump. Ethicon Endoloop ligatures can be used for this purpose but may be visualized on postoperative imaging which can create confusion for radiologists who may be concerned for a retained foreign body. Close communication between surgeons and radiologists about such findings is recommended.

P16 Endoloop ligatures in the retrieval of urethral foreign bodies: a narrative review

Abstract Introduction Self-insertion of foreign bodies into the urethra has been described previously in patients presenting to hospital emergency services. Treatment typically involves procedural retrieval under local anaesthesia using basket or forceps, cystoscopy, or open surgery. An Endoloop is a device designed to snare colonic polyps during endoscopy with nylon loops. It is not traditionally used for retrieval of urethral foreign bodies. Our objective was to determine the incidence, safety and efficacy of this approach. Methods A narrative review was performed. Primary outcomes were technical success, defined as uncomplicated retrieval of foreign body, and adverse events related to pain, bleeding, infection, and damage to structures. Electronic searches were performed using PubMed, Embase and Google Scholar. Reference lists of selected studies were searched manually. Results 2 case studies met inclusion criteria for analysis, both describing self-insertion of urethral foreign bodies for purposes of sexual arousal. These comprised a 30-year-old male (magnets) and a 29- year-old female (metal urethral sound). Both patients underwent successful retrieval of foreign body using an Endoloop ligature. There were no symptoms post-operatively and no procedural complications were reported. Conclusion An Endoloop ligature should be considered in conjunction with endoscopy when difficulties are experienced or anticipated with basket or forceps retrieval. Follow-up is mandatory to monitor for complications due to foreign body insertion such as urethritis, incontinence, fistula and diverticulum formation. Referral to psychological services is encouraged to reduce the risk of recurrence. Further studies are required to validate the efficacy and safety of this technique. Take-home message An Endoloop ligature should be considered in conjunction with endoscopy when difficulties are experienced or anticipated with basket or forceps retrieval of urethral foreign bodies.

Use of an Endoloop Ligature and a 2-Portal Coelioscopic Approach for the Removal of an Arrowhead Foreign Body in a Red-Tailed Hawk (Buteo jamaicensis).

A juvenile red-tailed hawk (Buteo jamaicensis) was presented to the Ontario Veterinary College from a wildlife rehabilitation facility for the assessment of an arrowhead foreign body injury. The hawk was found on the ground with the left wing in a dropped position. Radiographic images revealed an arrowhead foreign body superimposed over the left lung and thoracic air sacs, immediately medial to the ribs on the ventrodorsal view, and ventral to the scapulae on the right latero-lateral view. A coelioscopy was performed using a left lateral approach with a 2.7-mm rigid endoscope into the left caudal thoracic air sac, with an additional instrument port through the left abdominal air sac. The arrowhead was visualized adjacent to the left lung, separated from the cranial thoracic air sac cavity by a membrane of fibrous tissue. The tissue membrane was radiosurgically incised. Forceps were then used to guide an Endoloop around the arrowhead. The arrowhead was secured by tightening the Endoloop, and the body wall incision was extended to facilitate the arrowhead extraction.

Comparison between Endoloop ligature and Hem-o-lok clip (Polymer ligation) for appendiceal stump closure during laparoscopic appendicectomy

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients undergoing laparoscopic appendicectomy is Hem-o-lok clip safer than Endoloop ligature for closure of appendiceal stump?The search has been devised and 6 studies were deemed to be suitable to answer the question. The outcome assessed was the safety and cost effectiveness of Hem-o-lok clip (Polymer ligation) versus Endoloop ligature for appendiceal stump closure during laparoscopic appendicectomy. We concluded that Hem-o-lok clip is a safe and feasible tool for appendiceal stump closure. It's also a cost-effective way and could be a cheaper option compared to other measures.

Two Laparoscopic Appendectomy Techniques in Benign Gynecologic Surgery

<h3>Study Objective</h3> To demonstrate two laparoscopic appendectomy techniques used during gynecologic surgery for benign indications. <h3>Design</h3> Not applicable. <h3>Setting</h3> In both videos, patients were placed in the standard dorsal lithotomy position with moderate Trendelenburg tilt throughout the duration of the surgery. <h3>Patients or Participants</h3> Patients in both videos presented with chronic pelvic pain thought to be secondary to endometriosis. Their symptoms were refractory to medical management. After appropriate counseling, patients opted for diagnostic laparoscopy with possible endometriosis excision. Both patients were counseled on the risks and benefits of concurrent appendectomy at the time of surgery, and both have given their written consent. <h3>Interventions</h3> With the first technique, an ENDOLOOP ligature was used to double ligate the base of the appendix followed by excision using the laparoscopic scissors. The specimen was removed by using an Endo Catch specimen retrieval device. With the second technique, a 35 mm vascular stapler was used to seal and transect the appendix at the base. The specimen was removed directly from laparoscopic port. <h3>Measurements and Main Results</h3> We demonstrated two techniques for laparoscopic appendectomy. Both patients tolerated the procedures well, and their postoperative recovery was uneventful. The patient who underwent appendectomy with the stapler, pathology revealed evidence of acute appendicitis. <h3>Conclusion</h3> Appendiceal endometriosis is observed in 2.6% of patient who underwent surgery for endometriosis. ENDOLOOP ligature and vascular stapler are both well tolerated and effective method used in laparoscopic appendectomy. Gynecologists should attempt to incorporate routine assessment of the appendix during benign gynecologic surgeries and be able to perform concurrent appendectomy should the need arise.

Endoloops in laparoscopic appendicectomy: A retrospective, cost effectiveness analysis

BackgroundOver 50,000 appendicectomies are performed in the UK annually. Despite this highvolume. status, and the endoloop being commonly employed, there is a scarcity of literature studying differences in outcomes depending on numbers used.The aim of this study was to investigate whether a significant difference in complication rate exists where different numbers of endoloop ligatures have been applied to the appendiceal base during laparoscopic appendicectomy, and to analyse for potential cost saving. MethodsWe performed a retrospective analysis of appendicectomies at our centre in one year, providing a sample of 254 patients. Each was followed up for complications in the 30 days post discharge and graded using the Clavien-Dindo system. Our null hypothesis of no difference in complication rate was tested using Fisher's exact test. ResultsOf 254 patients, 59 were excluded due to open approach, non-endoloop method, or lack of available record, leaving a population of 195. The result of the two-tailed P value equalled 1.000, indicating no statistically significant difference in complication rate whether one or two endoloops were used. An endoloop costs £13.59. If the 62 cases in which 2 endoloops were used to secure the base had utilised a single endoloop, this would amount to a saving of £842.58. ConclusionOur study set out to assess whether the complication rate differs in cases where one or two endoloops have been applied. Retrospective statistical analysis found no significant difference between groups. Therefore, we recommend use of one endoloop to secure the base in laparoscopic appendicectomy.

Assessment of the haematological profile after appendectomy using linear titanium stapler clips: An experimental study in rats

Introduction: The technique of closing the appendiceal stump using linear titanium stapler clips is being used more and more frequently in laparoscopic surgery, despite the good practice in the use of resorbable single endoloop vicryl ligatures and/or the non-resorbable plastic hem-o-lok clips. No light has been shed on potential undesirable effects on the haemathological profile of the use of titanium stapler clips. This experimental study aimed at establishing any possible undesirable effect of linear titanium stapler clips and single resorbable vicryl endoloop ligatures on the blood cells in rats following appendectomy. Methods: A total of 70 adult rats were used, divided into a control group (n = 10), and two experimental groups (n = 30 + 30). The appendices were removed from the rats in the first experimental group using titanium stapler clips and in the second experimental group the appendiceal stump using resorbable endoloop vicryl ligatures was closed. In both experimental groups three sub-groups with ten animals each were formed, from which peripheral blood from a tail vein on days 7, 28 and 60 was removed postoperatively, in order to assess the usual haematological parameters. Stained blood smears were also analysed in order to establish any poikilocytotic erythrocytes present. Results: In the first experimental group, with the titanium stapler clips, more than 25 % neutrophils were found on day 7, which is a significantly different result (p &lt; 0.05) to the control group. In the second experimental group, there were more neutrophils than in the titanium stapler clips group, especially on days 7 and 60 and the results of these two sub-groups differ statistically significantly, p &lt; 0.05. Hypochromia was found in the endoloop vicryl ligatures group, as well as in the titanium stapler clips sub-group on day 28, due to lower haemoglobin values which were significantly different to the control group, p &lt; 0.05. Moderate levels of annulocytes, spherocytes and stomatocytes were found in most experimental groups. Conclusion: The results of this study favour the use of linear titanium stapler clips over resorbable single endoloop vicryl ligatures, because a less unfavourable effect was established on the blood cells of the experimental rats with their use.

Is Distal Partial Salpingectomy with an Endoloop Ligature Safe, Fast, and Effective for Nonisthmic Tubal Ectopic Pregnancy in Low-Socioeconomic Status Countries?

Objective: Total salpingectomy is the “gold standard” treatment for tubal ectopic pregnancy. This procedure avoids the risks of persistent trophoblasts and recurrent ipsilateral tubal pregnancies b...

1697 The Safety and Efficacy of Endoloop Ligation (“Loop-and-Let-Go”) of a Very Large Jejunal Lipoma

INTRODUCTION: Lipomas can occur anywhere throughout the gastrointestinal tract and can range widely in size. When symptomatic, these lipomas require removal, and several techniques have been described depending on the size of the lesion. Recently, a method utilizing an endoloop ligation has been proposed and validated for use in colonic lipomas. However, there remains a lack of literature on the safety and efficacy of endoloop ligation for the removal of symptomatic lipomas in the small intestine. CASE DESCRIPTION/METHODS: A 55-year-old male with a history of neurofibromatosis, prior prostate cancer, and tobacco use presented for evaluation of melena. He underwent an upper endoscopy which was reportedly normal and was transferred to our center for consideration of small bowel endoscopy. He continued to have melena and labile hemoglobin. A push enteroscopy revealed a long, submucosal lesion in the proximal jejunum with several areas of ulceration which were presumed to be the source of his bleeding. The mass was biopsied, and pathology was consistent with a lipoma. Subsequently, the patient underwent EUS and endoloop ligation. A video from this case is submitted to demonstrate the proper use of endoloop ligation of a large lipoma in the small intestine. Following placement of the endoloop ligature, the patient had no further bleeding and a follow-up enteroscopy one month later revealed complete loss of the lipoma with unremarkable appearing mucosa. DISCUSSION: In this case, we demonstrate that endoloop ligation is a safe technique for the removal of symptomatic large lipomas in the small bowel. In the video, we demonstrate how to apply the endoloop ligature to such a lesion effectively. Watch the video: http://bit.ly/2JSdmLE.

Preliminary Kidney Parenchymal Ligation Using Endoloop Ligatures—A Simple Method to Achieve a Trifecta in Laparoscopic Partial Nephrectomy Without Hilar Clamping for Polar Complex Tumors

To describe a novel and simple technique of preliminary kidney parenchymal ligation using Endoloop ligatures during laparoscopic partial nephrectomy (PN) without hilar clamping for polar complex tumor cases. The subjects were 17 patients who had a renal mass with a R.E.N.A.L. nephrometry score ≥7 (7/8/9/10 in 3/6/6/2 patients, respectively) located in the pole of the kidney. Patient-specific 3D reconstructed kidney images were created for preoperative planning in all cases. The renal hilar vessels were meticulously dissected and definitive tumor feeders were sacrificed when the branches directly perfused the peri-tumor area. Following the vascular microdissection, a circumferential cortex-depth incision on the kidney was made all around the tumor. Consequently, several Endoloop ligatures were placed in the incised tumor base to ligate the parenchyma preliminarily. Step-by-step Endoloop tightening facilitated effective parenchymal dissection without the urinary tract. After confirming that the tumor base parenchyma was ligated sufficiently, tumor resection was completed. Neither inner- nor outer-layer renorrhaphy sutures were placed. Perioperative outcomes were satisfactory and all patients had negative surgical margins with no damage in the tumor capsule. Urological complications and renal function lower than predicted at 3 months after surgery involved 1 and 3 cases, respectively. The rate of PN trifecta achievement was 82% (14/17) despite the complexity of the 17 tumors. The current technique helped surgeons achieve the trifecta in patients with polar complex masses treated with laparoscopic PN. Use of this technique can provide surgeons with a bloodless operative field even during PN without hilar clamping.

Cost Effectiveness of Different Methods of Appendiceal Stump Closure during Laparoscopic Appendectomy

There is no standard method for closure of an appendiceal stump during laparoscopic appendectomy. This study compares stump closure using a stapler with closure using an Endoloop ligature. The charts of all patients who underwent laparoscopic appendectomy at a single tertiary care center over a two-year period were reviewed for demographics, comobidities, operative details and costs, and outcomes. There were 325 patients who underwent a laparoscopic appendectomy. The majority, 250 (77%), underwent stump closure with a stapler. They were equivalent in demographics and postoperative complication rates. Cases using an Endoloop were slightly faster in terms of procedure time and room time, and less expensive in terms of operative supply cost. The price difference is not explained by time saved in the operating room and more likely by the equipment price.

Diagnostic accuracy and therapeutic relevance of thoracoscopic lung biopsies in children.

Histopathological assessment of lung biopsies does play an important diagnostic role in children's interstitial lung disease (ChILD). Thoracoscopic lung biopsy has been shown to be safe and effective. The aim of this study was to evaluate the diagnostic accuracy of thoracoscopic lung biopsies in children with ChILD. Furthermore, therapeutic relevance of the procedure, operative details, and perioperative complications of our series were investigated. We retrospectively reviewed all consecutive thoracoscopic lung biopsies taken from children with suspected ChILD in our institution over an 11-year period. Feasibility and complications were evaluated as well as histopathological diagnoses according to the recent ChILD classification and relevance of the procedure for medical treatment. Fifty-nine patients (54.2% male, median age 7 years [8 d-18 y]) underwent 112 thoracoscopic lung biopsies. An endostapler (27%), endoloop ligature (63%), or cut and suture technique (10%) were used. A chest tube was placed in 54% of the cases. Complications occurred in 15% of cases and mainly consisted of pneumothoraces or bleedings. Adequate tissue was obtained in all but one case and the biopsy led to a specific diagnosis according to the ChILD classification in 98%. Medical treatment of the underlying disease was changed due to the results of the biopsy in 86%. The diagnostic accuracy of thoracoscopic lung biopsies in children with suspected ChILD is high. The histopathologic results lead to a disease-specific treatment in the majority of the cases. Thoracoscopic lung biopsy is a safe and effective procedure with a low complication rate.

Closure of Appendicular Stump Using Absorbable Polydioxnon Endoclips in Laproscopoic Appendictomy

Background: Since 1983 when the 1st laparoscopic appendectomy was described by Semms, different methods for closure of the appendicular stump during laparoscopic appendectomy such as linear stapler (Endo GIA), endoloop ligature, intracorporeal suture and metal endoclips were used. The use of non-absorbable plastic clips was described in several studies which reported the low cost and easy application of these clips. Objective: to evaluate the efficiency of closure of appendicular stump using polydixanone AP 400 endosclips techniques as regard the intraoperative and postoperative complications. Patients: From October 2014 to October 2015, 40 patients from General surgery department Sohag university hospitals undergoing laparoscopic appendectomy with closure of appendicular stump using polydixanone AP 400 endosclips was done for all the patients. Primary outcome measures: were feasibility of the clip, intra-abdominal surgical site (abscesses, stump leakages) and superficial wound infections. Results: The staples were applicable in nearly 80% of patients. Reasons for not applying the clip were mainly aninflamed caecum or a too large diameter of the appendix base. Superficial wound infections were found in two (5%), intra-abdominal abscesses in one (2.5%), no leak from the appendicular stump was detected. Conclusions: The results suggest that the polydiaxnone endo clip is a safe and effective option in securing the appendicular stump in laparoscopic appendectomy.

Single-Incision Laparoscopic Surgery: Excision of Cornual Ectopic Pregnancy Made Simple Using ENDOLOOP

Abstract Background: Cornual or interstitial pregnancy is a rare subtype of ectopic pregnancy in which diagnosis may be elusive and treatment challenging. The laparoscopic approach has been used for treating this kind of pregnancy surgically whenever possible. However, reports on single-incision laparoscopic surgery (SILS) for treating cornual ectopic pregnancy are extremely sparse. This article describes a simplified SILS approach for treating a cornual ectopic pregnancy, using two ENDOLOOP® ligatures. With this technique, surgeons could find it easier to adopt SILS for treating cornual ectopic pregnancy. Case: A 27-year-old Chinese female presented with a spontaneous right cornual ectopic pregnancy of 8 weeks' gestation. She was in stable condition with a preoperative serum β–human chorionic gonadotropin (β-hCG) level of 16,673 IU/L. Single-incision laparoscopic excision of the pregnancy, using 2 ENDOLOOP ligatures, was performed. Her serial serum β-hCG levels were monitored. Results: The cornual ectopi...

Technical Aspects of Laparoscopic Surgery

Laparoscopic surgery is now an integral part of general surgery and is used in almost all known surgical procedures. There are many advantages to laparoscopic surgery, including faster patient recovery, shorter hospital stay, decreased pain and analgesic requirements, and faster return to work. A thorough understanding of the different technical aspects of laparoscopic surgery is necessary to perform procedures correctly, as well as to avoid certain predictable difficulties and complications that can occur. This review details operating room setup and patient and surgery team positioning; the laparoscope and instruments used; laparoscopic suturing; laparoscopic training and simulators; when and why to convert to open surgery; and the use of single-port or single-incision laparoscopic surgery. Figures show a schematic representation of a ceiling-mounted articulated boom for laparoscopic surgery; blueprints and photographs of the first endoscope; images of an articulated 5 mm scope and high-definition camera head, assorted laparoscopic instruments, 10 and 5 mm LigaSure sealing devices and a 5 mm Harmonic scalpel, an Endoloop ligature with a 2-0 polyglactin tie, various sizes of the 5 mm Nathanson retractor and the round Snake retractor, and 5 mm needle drivers and a 10 mm Endo Stitch suturing device; and an illustration of laparoscopic suturing (using a square knot). Tables list patient positions used for laparoscopic surgical procedures, guidelines for optimal laparoscopic surgery suites, and staple heights and colors. This review contains 9 figures, 2 tables, and 78 references.

Single Incision Laparoscopic Excision of Cornual Ectopic Pregnancy Made Simple Using Endoloop®

Abstract Background: Cornual or interstitial pregnancy is a rare subtype of ectopic pregnancy in which diagnosis may be elusive and treatment challenging. The laparoscopic approach has been used for treating this kind of pregnancy surgically whenever possible. However, reports on single-incision laparoscopic surgery (SILS) for treating cornual ectopic pregnancy are extremely sparse. This article describes a simplified SILS approach for treating a cornual ectopic pregnancy, using two ENDOLOOP® ligatures. With this technique, surgeons could find it easier to adopt SILS for treating cornual ectopic pregnancy. Case: A 27-year-old Chinese female presented with a spontaneous right cornual ectopic pregnancy of 8 weeks' gestation. She was in stable condition with a preoperative serum β–human chorionic gonadotropin (β-hCG) level of 16,673 IU/L. Single-incision laparoscopic excision of the pregnancy, using 2 ENDOLOOP ligatures, was performed. Her serial serum β-hCG levels were monitored. Results: The cornual ectopi...

Comparison of Clinical Outcomes between the Hem-o-lok Clip and Endoloop Ligature in Securing the Base of the Appendix

Purpose: There are various techniques for securing the base of the appendix during performance of laparoscopic appendectomy. Many studies have reported that Endo-GIA is useful for securing the base of the appendix; however, it is costly. Many hospitals now use Endoloop ligature (ELL) for securing the base of the appendix. Many studies have demonstrated the many advantages of the Hem-o-lok clip (HLC) for securing the base of the appendix. The aim of this study is to compare the surgical outcomes of securing the base of the appendix between HLC and ELL during performance of laparoscopic appendectomy. Methods: A retrospective cohort study was conducted for comparison between HLC and ELL for securing the base during performance of laparoscopic appendectomy. From May 2008 to October 2011, 102 patients underwent laparoscopic appendectomy performed by a single surgeon. Thirty one patients were excluded for various reasons. In 38 patients, the base of the appendix was secured by HLC, and in 33 patients, ELL was applied. Data included age, sex, body mass index (BMI), cost of materials, preoperative white blood count (preoperative WBC), preoperative c-reactive protein (preoperative CRP), preoperative fever, operation time, hospital days, diameter of the appendiceal base, number of perforated appendicitis, and intraoperative or postoperative complication. Results: HLC was used in 38 patients, with a mean age of 36.4 years old. ELL was applied in 33 patients, with a mean age of 19.3 years old. Significant difference in age of patients was observed between the groups (p ＜0.001). The groups were comparable with regard to sex, BMI, preoperative WBC, preoperative CRP, preoperative fever, operation time, hospital stay, diameter of the appendiceal base, perforated appendicitis, and intraoperative or postoperative complication. The cost of six HLCs was 32,940 won, and that for one ELL was 29,610 won, therefore, there was no significant difference in the cost of material betw een the tw o groups of patients. Conclusion: Except for age, no difference was observed betw een the tw o groups. If a single HLC set is available for securing the base of the appendix, there will be a significant difference of the material cost between the two groups. ELL is more useful for securing the appendiceal base, with a larger diameter, which is inappropriate for use of HLC.