Page 4 - WJOLS - Laparoscopic Journal

Ali Aminian et al

Application of the clips at the base of appendix is done by a
special applier for the Hem-o-lok clip (Fig. 3A). Only one
Hem-o-lok clip, size L or XL is placed at 90º to the base of
the appendix on the proximal part and one on the distal part
which would be removed (Figs 4A to F). We did not
encounter any complications related to the use of Hem-o-lok
clips, such as bleeding or leakage from appendiceal stump.

DISCUSSION
In practice, this mode of port placement offers several
benefits. Two ports can be inserted below the pubic hairline
with no visible scars. This modification not only improves
the cosmetic result but also provides optimal ergonomics.
Fig. 2: Optimal working space: Optical axis lying between the two First, the telescope, pointing upward and to the right, affords
working instruments with wide manipulation angel much better visualization of the base of appendix (see Fig. 2).

A B

C D

E
Figs 3A to E: Hem-o-lok clips and applier

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