Aim: This study aimed to compare the hem-o-lok polymeric clip (HC) and tri-staple (TS) methods used in dividing the splenic hilum in terms of results, and to reveal their superiority to each other.

Material And Methods: Medical records of patients undergoing elective laparoscopic splenectomy at the Ondokuz Mayis University Faculty of Medicine General Surgery Clinic between March 2011 and March 2020 were retrospectively analyzed. Forty-two laparoscopic splenectomy cases performed using hem-o-lok polymeric clip (HC) or tri-staple (TS) were included in this study. Demographic features, primary diagnoses, splenic size, intraoperative data and postoperative complications, as well as the clip and stapler prices used in the surgery were analyzed.

Results: The mean operative time was significantly longer for HC group than TS group (116.7 min vs. 87.6 min, p<0.05). The mean cost of surgical instruments used to divide the splenic hilum was significantly lower for HC group than TS group (34.1 usd vs. 165.4 usd, p<0.05). There was no postoperative mortality, with a morbidity rate 6 (26.1%) for TS group and 4 (21.1%) for HC group (p>0.05). No significant difference existed in the complication rates.

Conclusions: In the HC group, the operation time was longer, but the surgical cost was significantly lower. There was no significant difference when comparing other perioperative results. Although both techniques can be applied safely, we would like to emphasize that hemostasis is the most important factor for good results.

Key Words: Hem-o-lok polymeric clip, Laparoscopic splenectomy, Tri-staple.

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Purpose: Polymeric clips (Hem-o-lok ligation system) are now widely used to securing the base of the appendix during laparoscopic appendectomy. Studies comparing the use of single or double hem-o-lok clips are limited. The aim of this study was to compare the reliability of a single hem-o-lok clips with a double hem-o-lok clips for closure of an appendiceal stump.

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Medicine (Baltimore)

October 2023

Department of Pathology, People's Hospital of Wanning, Wanning, Hainan, P. R. China.

Rationale: The Hem-o-lok clip, made from a nonabsorbable polymer, and its predecessor the metal ligation clip have been used widely for laparoscopic or robot-assisted surgery to ligate the cystic duct after a cholecystectomy, to ligate the appendix after an appendectomy, or control hemorrhage or on occasion to occlude a fistula or enterotomy. Displacement of these ligation clips to distant sites is an extremely rare complication in clinical practice.

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Objectives: To evaluate Hem-o-Lok polymer clips' feasibility, safety and cost-effectiveness in controlling the splenic pedicle during paediatric laparoscopic splenectomy.

Method: The prospective study was conducted from May 2019 to December 2021 at Kafrelsheikh University Hospital, Egypt, and comprised children of either gender aged <18 years who had benign haematological diseases and were indicated for laparoscopic splenectomy. During the procedure, Hem-o-Lok clips were used for controlling the splenic pedicle.

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