Comparison of the Electrothermal Vessel-Sealing System Versus Endoclip in Laparoscopic Appendectomy

Abstract

The use of LigaSure facilitates the dissection of mesoappendix and shortens the operation time in LA. We believe that LigaSure is a safe, useful tool for mesoappendix dissection.

Does the Use of Newer Technology to Divide the Mesoappendix Result in Less Bleeding? A Retrospective Analysis

“…When dealing with an extremely inflamed, gangrenous, or perforated appendix, using an energy source might intuitively seem to be advantageous; however, our data seem to demonstrate otherwise. The surgeon can use either of these energy sources to divide the mesoappendix without excessive dissection or isolation of the appendicular artery, leading to quicker division with minimal bleeding [4,5,9]. Using an Endo-GIA stapler, endoloops, or endoclips may require more meticulous dissection to safely isolate and divide the mesoappendix.…”

“…Although the literature has shown the utility of using energy sources, both the Endo-GIA stapling device and endoloops are valid and acceptable options [4,5]. When operating for early acute appendicitis, there is minimal inflammation and edema of the surrounding tissue, thus gaining control of the mesoappendix can be accomplished easily using endoloops or an Endo-GIA stapler with minimal manipulation of the tissues.…”

“…Meta-analyses of randomized-controlled trials have shown that laparoscopic appendectomy has several advantages over the open approach, including faster convalescence, less postoperative pain, better cosmetic results and fewer wound infections [1][2][3]. Prior studies have shown that the most common reason to convert to an open appendectomy is bleeding, specifically bleeding during the dissection and sealing of the mesoappendix [1][2][3][4][5][6][7][8]. As new technology emerges, it is imperative to examine and critically appraise new technology in terms of efficiency, quality and cost effectiveness.…”

Ein Review der laparoskopischen Appendektomie

“…Neue Ultraschall oder elektrothermi sche Dissektionsgeräte wurden zur Prä paration des Mesoappendix vorgeschla gen, aber obwohl es eine Reduzierung bei Operationsdauer (41 vs. 54 min) und Kon versionsraten (9,4 vs. 11,1%) in einer einzi gen RCT [28] gibt, scheint der Nutzen die Kosten nicht aufzuwiegen.…”

Histopathological Response and Adhesion Formation After Omentectomy with Ultrasonic Energy, Bipolar Sealing, and Suture Ligation

“…Energy-based devices such as the Ultracision Harmonic Scalpel (Ethicon Endo-Surgery, Inc., Cincinnati, OH; ultrasonic coagulator (UC)) and the LigaSure (Covidien Valleylab, Boulder, CO; bipolar vessel-sealing device (BP)) have increasingly been used in both conventional and laparoscopic surgeries [3][4][5]. BP is an electrothermal vessel-sealing system presented as an alternative to sutures, hemoclips, staplers, and ultrasonic coagulators for ligating vessels.…”