Background \nIt’s generally assumed that surgery in hemophilia can be accomplished safely these days.\n\nThe aim of the this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in hemophiliacs.\n\nMethods\n\nTwo patients with mild hemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min. before surgery. Incision of the skin was done with a pure cut mode, subcutaneous tissue with a ValleylabTM mode and any vascularized tissue and vessels were sealed and cut with a LigaSureTM 5 mm instrument. Laparoscopic access was obtained with three ports of\nVersaStepTM PLUS, a radially expandable access system. Confluence of the appendix and cecum was stapled with Endo GIA™ 30 mm reload with the Tri-Staple™ technology. Postoperatively, the replacement therapy was continued according to the international guidelines for the management of hemophilia.\n\nResults\n\nThe operative and post-operative periods were uneventful. No significant differences were found in the operation time in our hemophilic patients versus non-hemophilic patients. Significant differences related to the duration of hospital stay was found in both patients compared with controls, due to the necessary replacement therapy.\n\nConclusion\n\nWith new surgical technologies, proper and permanent hemostasis can be achieved, without prolonging the operation time.