LigaSure compared with ligatures and endoclips in experimental appendectomy: how safe is it?
OBJECTIVE
The present study aims to compare strength, healing, and inflammation of appendiceal stumps closed by LigaSure Precise (Valleylab, Boulder, CO, USA) device, ligatures using polyglactin 910 (Vicryl, Ethicon, Edinburgh, UK) and endoclips (Ligaclip ERCA, Ethicon, OH, USA), and operation time (OT) in experimental appendectomy.


METHODS
Forty-eight Sprague-Dawley rats were divided into two (Group A and B). Each group was further subdivided into three subgroups (AS, AC, AL, BS, BC, BL) containing eight rats. Appendectomy was performed and stump was closed by ligatures in S, by endoclips in C and by LigaSure in L subgroups. OT was recorded. In Group A, cecum bursting pressures (BP) were determined instantly after the operation. In Group B, BP, histological evaluations, and measurements of collagen contents estimated by the tissue hydroxyproline (HPL) level were made on the seventh postoperative day. Statistical analyses were performed with Kruskal-Wallis test and Mann-Whitney U test. P value was considered significant at less than 0.05.


RESULTS
BPs of subgroups were comparable on postoperative immediate period and day 7. HPLs and OTs were significantly better in L subgroups. BL had the least inflammation.


CONCLUSIONS
Better healing, less inflammation, shorter OT, and equal strength achieved with LigaSure device comparing with polyglactin 910 ties and endoclips in experimental appendectomy is encouraging.
Department of Pediatric Surgery, Medical Faculty, Kocaeli University, Kocaeli, Turkey. elemenlevent@hotmail.com
Levent
L
Elemen
Yusufhan
Y
Yazir
Melih
M
Tugay
Alper
A
Akay
Seval
S
Aydin
Karolin
K
Yanar
Süreyya
S
Ceylan
D000818:Animals; D001062:Appendectomy / Q000295:instrumentation*; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006909:Hydroxyproline / Q000378:metabolism; D008026:Ligation / Q000295:instrumentation; D011098:Polyglactin 910; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D018709:Statistics, Nonparametric; D014945:Wound Healing / Q000502:physiology
D011098:Polyglactin 910; D006909:Hydroxyproline