Retrospective comparison of hem-o-lok clip and intracorporeal suture as stump closure methods in laparoscopic appendectomy

Yıl 2025, Cilt: 30 Sayı: 3, 390 - 395, 25.09.2025

Mustafa Yılmaz , Burak Altunpak

https://doi.org/10.21673/anadoluklin.1598377

Öz

Aim: Purpose: The choice of appendix stump closure method in laparoscopic appendectomy for surgical treatment of acute appendicitis is a controversial issue among surgeons. Hem-o-lok clips and intracorporeal sutures are commonly used techniques for this purpose. This study aims to compare the results of hem-o-lok clips and intracorporeal sutures in closing the appendix stump during laparoscopic appendectomy.

Methods: Between January 1, 2023 and October 1, 2024, patients who underwent laparoscopic appendectomy for noncomplicated acute appendicitis, who were over 18 years of age, non-pregnant, and whose histopathologic data were compatible with acute appendicitis were retrospectively reviewed using electronic medical records. Patients were divided into two groups as group 1 (hem-o-lok clip) and group 2 (intracorporeal suture). Data were compared between the groups.

Results: 196 patients were included in the study. 96 (49%) were female, 100 (51%) were male, mean age was 30.59 (18-61). There were 92 patients in the hem-o-lok group (40 (43.5%) female, 52 (56.5%) male, mean age: 32.43 (18-61)) and 104 patients in the intracorporeal suture group (56 (53.8%) female, 48 (46.2%) male, mean age: 28.96 (18-50)). There was no significant difference between the two groups in terms of age, gender, American Society of Anesthesiologists Score, length of hospital stay and postoperative complications (p>0.05). The mean operation time was 42.91±9.93 minutes in the hem-o-lok group and 54.19±13.93 minutes in the intracorporeal suture group (p<0.001). The cost of suture use was insignificant compared to hem-o-lok clip (35 versus 280 ).

Conclusion: Both hem-o-lok clips and intracorporeal suture are safe methods in laparoscopic appendectomy. Although hem-o-lok clips shorten the operation time, they are costly. Intracorporeal knotting, on the other hand, is less costly and is recommended because it helps surgeons to improve their laparoscopic skills.

Anahtar Kelimeler

Appendicitis , appendectomy , laparoscopic , stump , suture techniques

Laparoskopik apendektomide güdük kapama yöntemlerinden hem-o-lok klip ve intrakorporeal sütürün retrospektif karşılaştırması

Öz

Amaç: Akut apandisit cerrahi tedavisi laparoskopik apendektomide apendiks güdüğünü kapatma yönteminin seçimi, cerrahlar arasında tartışmalı bir konudur. Hem-o-lok klips ve intrakorporeal sütürler bu amaçla yaygın olarak kullanılan tekniklerdir. Bu çalışma, laparoskopik apendektomi sırasında apendiks güdüğünün kapatılmasında hem-o-lok klips ve intrakorporeal sütürlerin sonuçlarını karşılaştırmayı amaçlamaktadır.

Yöntemler: 1 Ocak 2023 ve 1 Ekim 2024 tarihleri arasında, nonkomplike akut apandisit tanısıyla laparoskopik apendektomi yapılan, 18 yaş üstü, gebe olmayan ve histopatolojik verileri akut apandisit ile uyumlu olan hastalar elektronik tıbbi kayıtları kullanılarak retrospektif olarak incelendi. Hastalar grup 1 (hem-o-lok klip), grup 2 (intrakorporeal sütür) olmak üzere iki gruba ayrıldı. Veriler gruplar arasında karşılaştırıldı.

Bulgular: 196 hasta çalışmaya dâhil edildi. 96 (%49) kadın, 100 (%51) erkek, ortalama yaş 30,59 (18-61) idi. Hem-o-lok grubunda 92 hasta (40 (%43,5) kadın, 52 (%56,5) erkek, ortalama yaş 32,43(18-61)) ve intrakorporeal sütür grubunda 104 hasta (56 (%53,8) kadın, 48 (%46,2) erkek, ortalama yaş 28,96(18-50)) vardı. İki grup arasında yaş, cinsiyet, Amerikan Anestezistler Derneği Skoru, hastanede kalış süresi ve postoperatif komplikasyonlar açısından anlamlı bir fark yoktu (p>0,05). Ortalama operasyon süresi hem-o-lok grubunda 42,91±9,93 dakika, intrakorporeal sütür grubunda 54,19±13,93 dakika idi (p<0,001). Sütür kullanımının maliyeti hem-o-lok klipse kıyasla önemsizdi (35 ‘ye karşı 280 ).

Sonuç: Laparoskopik apendektomide hem hem-o-lok klips hem de intrakorporeal sütür güvenli yöntemlerdir. Hem-o-lok klipsler operasyon süresini kısaltsa da maliyetlidir. İntrakorporeal düğümleme ise daha düşük maliyetli olup, cerrahların laparoskopik becerilerini geliştirmesine katkı sağladığı için önerilmektedir.

Anahtar Kelimeler

Apandisit , apendektomi , güdük , laparoskopik , sütür teknikleri

Kaynakça

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