Comparison of bipolar electrosurgical devices with ligatures and endoclips in the rat appendicitis model.
OBJECTIVE
The aim of this study is to compare bipolar radiofrequency-driven vessel sealer, bipolar electrocautery, polyglactin 910 sutures, and endoclips in appendiceal stump closure with respect to operative time, appendiceal stump strength, and inflammation in a rat appendiceal model.


METHODS
Forty-eight Wistar-Albino rats, which had previously created appendicitis, were divided into 2 (groups A and B). Each group was further subdivided into 4 subgroups (AL, ABPC, AC, AS, BL, BBPC, BC, and BS) each containing 6 rats. An appendectomy was performed, and the stump was closed by bipolar radiofrequency-driven vessel sealer in the L, bipolar electrocautery in the BPC, endoclips in the C, and ligatures in the S subgroups. Cecum bursting pressures were determined instantly after the operation in group A and on the seventh postoperative day in group B. All operative times were measured. Appendices and appendiceal stumps underwent histopathologic examination. Statistical analyses were performed with Kruskal-Wallis and Mann-Whitney U tests. P < .05 was considered significant.


RESULTS
Bursting pressures of the subgroups were comparable on postoperative immediate period and day 7. Operative times were significantly shorter in the L and BPC subgroups in A and B. Histopathologic examination showed that the inflammation scores were similar in group A. In group B, inflammation parameters were also similar except the necrosis status, which was found to be decreased in BL compared with BC and BS. Necrosis status was significantly lower, and lymphocyte quantity was significantly higher in BL and BBPC compared with AL and ABPC.


CONCLUSIONS
Bipolar radiofrequency-driven vessel sealer and bipolar electrocautery achieve safe stump closure with satisfactory bursting pressure values in an experimental rat appendicitis model. Decreased operative time and unimpaired healing are encouraging.
Kocaeli University Medical Faculty, Department of Pediatric Surgery, Kocaeli, Turkey. elemenlevent@hotmail.com
Levent
L
Elemen
Yusufhan
Y
Yazir
Alper
A
Akay
Zehra
Z
Boyacıoğlu
Bahar
B
Ceyran
Süreyya
S
Ceylan
D000818:Animals; D001062:Appendectomy / Q000295:instrumentation* / Q000379:methods; D001064:Appendicitis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002432:Cecum / Q000473:pathology; D019245:Compressive Strength; D004564:Electrocoagulation / Q000295:instrumentation*; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D008026:Ligation; D008297:Male; D023421:Models, Animal; D009852:Omentum / Q000473:pathology; D010538:Peritonitis / Q000209:etiology; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D013525:Surgical Instruments