Two different methods for appendiceal stump closure: metal clip and Hem-o-lok clip.

ABSTRACT

INTRODUCTION: Closure of the appendiceal stump (CAS) is the most crucial part of appendectomy procedures because most of the complications occur by a leak of the stump. The aim of this retrospective clinical study is to emphasize two different methods (metal clip and Hem-o-lok(®) [Teleflex Medical, Research Triangle Park, NC] clip) for CAS. MATERIALS AND METHODS: The cases were divided into two subgroups according to the type of CAS. Subgroups were compared with each other according to age, intraabdominal abscess formation, operation duration, and complication rate. RESULTS: No intraoperative complications were seen in either subgroup. There were 22 postoperative complications in the metal clip subgroup (13 intraabdominal abscesses, 9 wound infections) and 8 postoperative complications in the Hem-o-lok clip subgroup (five intraabdominal abscesses, three wound infections). The cost of the closure was $7 for the metal clip group and $50 for the Hem-o-lok clip group. CONCLUSIONS: The use of Hem-o-lok clips and metal clip for CAS in laparoscopic appendectomy is a feasible, safe, and cost-effective procedure in patients with a mild to moderately inflamed appendix base of less than 10 mm in diameter.