Background: The most common surgical disease is acute appendicitis. Appendicular stump closure is the most crucial part in appendectomy. The aim of the present study was to compare outcomes of Hem-o-lok clip and extracorporeal sliding knot in appendicular stump closure during L-APPE.

Methods: This study was designed as prospective randomized clinical trial for evaluation of the outcomes of appendix stump closure with Hem-o-lok clip or extracorporeal sliding knot during L-APPE. This study was carried out in Zagazig University Hospitals, Egypt. All patients diagnosed as acute appendicitis patients and operated by L-APPE at Zagazig University Hospital during the period from 1st of September 2020 till 31st of March 2022 were assessed for study eligibility.

Results: In total, 160 patients (80 patients in each arm) were enrolled into the study. No difference in hospital stay in both groups but operative time was noted in the hem-o-lok group (group I) of patients 35.45 ± 9.24 minutes in Hem-o-lok group , but in the extracorporeal knot group (group II) it was 44.15 ± 7.51 minutes. Regarding postoperative complications, 2 patients (2.5%) within group I had superficial infection versus three patients (3.8%) within group II. While two patients (2.5%) within group I had one patient (1.2%) deep infection versus within group II overall 3 cases (1.8%) of deep infection in both groups

Conclusions: Hem-o-lok clip is safe and effective method in appendicular stump closure during L-APPE with less operative time.