Evaluation of Intra-corporeal Ligation of the Mesoappendix during Laparoscopic Appendectomy versus the Use of Energy Devices: A Comparative Study | ||
| Ain Shams Journal of Surgery | ||
| Volume 15, Issue 2, July 2022, Pages 117-124 PDF (763.04 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2022.246359 | ||
| Authors | ||
| Hatem Elgohary1; Ramy Mikhael2; Islam ElAbbassy2 | ||
| 1General Surgery Department, Faculty of Medicine, Helwan University, Cairo, Egypt | ||
| 2General 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. | ||
| Keywords | ||
| Laparoscopic appendicectomy; monopolar diathermy; Harmonic scalpel; mesoappendix | ||
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