Evaluation of Stump Pressure in Three Types of Appendectomy: Harmonic Scalpel, LigaSure, and Conventional Technique.
OBJECTIVE
Appendectomy is one of the most common operations carried out by general surgeons. The recent introduction of the alternative energy-based devices in surgery and their use in the laparoscopic appendectomy shortened the duration of operations, but these devices are used generally for meso dissection. These devices did not receive wide acceptance among surgeons as there is not enough evidence confirming their use in appendicular lumen operations. Our objective in this study was to test the safety of three types of appendectomy.


METHODS
Twenty-four cases with right hemicolectomy or subtotal colectomy were enrolled into this study. The patients were distributed in three groups. After the colectomy specimen was removed, in Group 1 conventional appendectomy (it was dissected with mesoappendiceal fixation and with electro cauterization) was performed in the operating room, the appendicular stump was ligated with a silk suture; in Group 2 appendectomy was performed with LigaSure™ and the stump was closed also with LigaSure; in Group 3 appendectomy was performed with Harmonic Scalpel™ and the stump was closed also with Harmonic Scalpel. Stump opening pressures were measured in all patients in the groups.


RESULTS
Three groups were compared in terms of age, gender, concomitant diseases, clinical diagnosis, previous operations, pathological findings, and applied maximum pressure levels. No statistical difference was detected among the groups.


CONCLUSIONS
Appendectomies carried out with LigaSure and Harmonic Scalpel are as safe as appendectomies carried out with the conventional methods.
1 Department of General Surgery, Kecioren Training and Research Hospital , Ankara, Turkey .
Alper
A
Yavuz
1 Department of General Surgery, Kecioren Training and Research Hospital , Ankara, Turkey .
Hakan
H
Bulus
2 Department of General Surgery, Mustafa Kemal University , Hatay, Turkey .
Adnan
A
Taş
1 Department of General Surgery, Kecioren Training and Research Hospital , Ankara, Turkey .
Altan
A
Aydın
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000379:methods*; D003082:Colectomy; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D008026:Ligation / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011312:Pressure; D066231:Surgeons; D013525:Surgical Instruments; D013536:Suture Techniques; D013537:Sutures; D055815:Young Adult
leakage; reinforcement; sleeve gastrectomy