Evaluation of Intra-corporeal Ligation of the Mesoappendix during Laparoscopic Appendectomy versus the Use of Energy Devices: A Comparative Study

Document Type : Original Article

Authors

1 General Surgery Department, Faculty of Medicine, Helwan University, Cairo, Egypt

2 General Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: Studies showed that using Harmonic scalpel for devascularization of the mesoappendix in laparoscopic
appendicectomy (LA) is quick and safe. However, in order to reduce the cost of the procedure, endo-clips or
monopolar electrocautery are considered cheaper alternatives. The aim of our study was to evaluate the use of
intra-corporeal ligation as an alternative safe and cost-effective way to devascularize the mesoappendix.
Methods: The study included 180 patients who were randomly divided into three equal groups: Group 1 (Intracorporeal
ligation of mesoappendix combined with monopolar diathermy), group 2 (Division of mesoappendix by
Harmonic scalpel), and group 3 (division of mesoappendix by monopolar diathermy). All groups were compared
regarding operative time, rate of conversion to open, intra-operative bleeding, postoperative pain, length of hospital
stay (LOS), postoperative complications and the cost of consumables used.
Results: There was a statistical significant intra-operative bleeding in groups 2 and 3 compared to group 1. The
cost of consumables used in group 1 were significantly cheaper compared to using Harmonic scalpel . There was
no significant difference regarding the rest of the parameters.
Conclusion: Intra-corporeal ligation of the mesoappendix is safe and cost-effective when compared to the use of
Harmonic scalpel or monopolar diathermy alone.

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