A Systematic Review of Post-surgical Adverse Events Related to Hem-O-Lok Clips: A Commonly Used Device With Potential...

Area of Science:

• Surgical Devices
• Minimally Invasive Surgery
• Urology
• Gastroenterology

Background:

• Hem-o-lok clips (HOLCs) are widely used in minimally invasive surgery for vascular pedicle control and hemostasis.
• While generally safe, HOLCs have been associated with various reported complications.

Purpose of the Study:

• To systematically review and summarize complications associated with Hem-o-lok clip usage from 1999 to 2025.
• To identify the incidence and types of complications following HOLC application in surgical procedures.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines.
• Searches conducted on PubMed, Google Scholar, ResearchGate, and Embase for English-language articles.
• Inclusion of studies reporting complications from January 1999 to December 2025.

Main Results:

• Post-prostatectomy complications were most frequent (66.23%), followed by laparoscopic cholecystectomy (14.28%).
• Common complications include clip migration with urinary stone formation (45.45%), bladder neck contracture (14.29%), and ureteral migration (14.29%).
• Other reported issues include duodenal erosion, CBD obstruction, and rectal or esophageal migration.

Conclusions:

• Hem-o-lok clips, despite general safety, can lead to rare but significant complications.
• Early diagnosis requires a high clinical suspicion.
• Management typically involves endoscopic retrieval, with conservative options for asymptomatic cases.