Efficacy and Safety of LigaSure in Laparoscopic Sutureless Appendectomy

Gupta, Viney; Chauhan, Somendra Pal Singh; Gupta, Mayank; Verma, Ramlakhan; Singh, Shailendra; Panday, Anand

doi:10.7759/cureus.24764

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…Thanks to the data obtained from these studies, there have been studies in human studies demonstrating that the use of LigaSure is safe for the closure of appendix stump in pediatric and adult age groups. 13,14 Since there is no study comparing the use of LigaSure with other methods for the closure of the appendix stump in humans, this study is a pioneering study in this regard. Our study did not find a difference between the use of hemoclip or LigaSure as the method of closing the appendix stump, which applied to similar groups, in terms of safety and complications.…”

Section: Discussionmentioning

confidence: 99%

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Is LigaSure Alone Sufficient for the Closure of the Appendix Stump?

Tazeoglu,

Cem Esmer

2024

Surg Innov

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Purposes Closure of the appendix stump is necessary for laparoscopic appendectomy. Problems that occur during the appendix stump closure can cause severe morbidity. Several methods of stump closure have been described. This study aimed to investigate the adequacy of LigaSure alone in closing the appendix stump. Methods Patients who were operated on with the diagnosis of acute appendicitis between October 2021 and January 2022 were evaluated retrospectively. The patients were divided into two groups according to the closure technique of the appendix stump hemoclip(group I) and LigaSure only(group II). In addition, demographic data (age, gender), body mass index (BMI), presence of comorbid disease, perioperative appendicitis classification, operation time, postoperative hospital stay, radiological and pathological appendix size of the patients included in the study were recorded. Clavien Dindo was used for postoperative complication assessment. Result The study included 77 patients. 48(62.3%) of the patients were in group I, and 29(37.7%) were in group II. There was no statistical difference between the groups regarding age, gender distribution, BMI, presence of comorbid disease ( P > .05). The operation time of group I was longer than group II ( P < .001). There was no difference between the groups in terms of both radiological and pathological appendix size. There was no statistical difference between the groups regarding postoperative complications and severity of complications ( P = .76, P = .99, respectively). Conclusion Appendiceal stump closure can be performed with Ligasure, but it should be noted that this procedure can be performed on selected patients, as in the study group, not on all patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is LigaSure Alone Sufficient for the Closure of the Appendix Stump?

Tazeoglu,

Cem Esmer

2024

Surg Innov

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“…Gupta et al [ 38 ] reported a series of 53 patients aged between 11 and 60 years with a successful appendectomy using a 5 mm LigaSure TM instrument that was repeatedly applied to obtain a resection. This also supports our findings, namely, that the 5 mm instrument achieves resection after repeated application.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the use of the LVSS in the division of the mesoappendix during laparoscopic appendectomy has been reported by both Aydogan et al [ 35 ] and Sucullu et al [ 36 ] in a series of 127 and 32 cases, respectively, with good results. Transection of the apex ceaci is mainly reported in animal models [ 37 ]; conversely, Gupta et al [ 38 ] reported a series of 53 patients with successful appendectomies using a 5 mm LigaSure TM instrument.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Appropriate LigaSure™ Device to Transect the Appendix—A Comparison between 5 mm and 10 mm Laparoscopic Devices in an Ex Vivo Trial

Turial

Schwind²,

Nyiredi

2023

Medicina

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Background and Objectives: A topic of greatinterest in the surgical field comprises cost and time reduction operative techniques with high efficiency rates. Thus, the aim of this paper is to evaluate whether a transection of the appendix using only a laparoscopic LigaSure™ device is feasible and, if so, which size of the laparoscopic device is optimal. Materials and Methods: Appendectomy specimens were sealed and cut using LigaSureTM V (5 mm) and LigaSure AtlasTM (10 mm) devices ex vivo. Analysis criteria included handling, resistance to bursting pressure of the appendicular stump (adequacy), eligibility, durability and airtightness. Results: Twenty sealed areas were measured. While the 5 mm instrument was not able to transect the appendix in one attempt in any of the cases, the 10 mm device could be applied successfully without any handling difficulties. The adequacy of the sealed area was rated as complete and dry in all 10 cases using the 10 mm device and as oozing in 8 of the cases using the 5 mm device. There was no leakage in terms of air and liquid tightness using the 10 mm device, in contrast to six sealed segments with air and liquid leakage when using the 5 mm device. The resistance to bursting pressure was on average 285 mmHg and 60.5 mmHg with the 10 mm and 5 mm devices, respectively. The durability and eligibility of the 10 mm device were rated as very sufficient in 9 of 10 cases (1 perforation) in contrast to the 5 mm device, where the sealing in 9 of 10 cases was not sufficient (9 perforations). Conclusions: Using the 10 mm laparoscopic LigaSure™ device for the transection of the appendix seems to be feasible, safe and resistant to 300 mmHg bursting pressure. The 5 mm LigaSure™ instrument is inadequate to seal the appendix in humans.

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“…The most crucial step in this operation is to seal the appendiceal stump securely, that is why research on the subject is still being done [7]. The base of the appendix can be secured using a variety of techniques, including energy-based devices, metallic or plastic clips, staplers, or suture materials (extracorporeal or intracorporeal) [8]. All method has advantages and disadvantages of their own.…”

Section: Introductionmentioning

confidence: 99%

Closure of the appendix stump with two different suture materials in laparoscopic appendectomy in children

Uzunlu¹

2023

Pam Tıp Derg

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Purpose: To evaluate the outcomes of the closure of the appendix base using two different suture materials that we used in our clinic with those published in the literature. Materials and methods: The study retrospectively reviews 36 cases of children who underwent laparoscopic appendectomies. The patients were divided into two groups: the Vicryl suture group and the silk suture group. Laboratory results, diagnostic algorithms, surgical techniques, and complications were investigated. Results: Sixteen (44%) of the cases were male, and twenty (56%) were female. All patients' mean hospital admission time was 2.22±1.6 days (range: 1–7 days). The mean WBC and CRP levels were 14.67±5.8x109/L, 139.3±120 mg/L in the vicryl group and 15.36±6.4x109/L and 86±80 mg/L in the silk group. Small bowel obstruction was observed in nine patients in the vicryl group and six patients in the silk group. Ultrasonography was performed in 31 of the cases, the appendix was visualized in 21 cases (67%).Intravenous contrast-enhanced CT imaging was applied in 25 cases. At laparoscopic exploration, 20 cases were classified as complicated—17 due to perforation, and 3 due to gangrene. All cases were treated with broad-spectrum antibiotics. The mean follow-up period was 43 months (range: 10-117 months); none of the patients experienced intraoperative complications, and only two patients had minor complications in the postoperative period. Conclusion: In all circumstances and regardless of the appendix's diameter, the appendix stump can be securely closed with both silk and vicryl suture material.

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Efficacy and Safety of LigaSure in Laparoscopic Sutureless Appendectomy

Cited by 6 publications

References 23 publications

Is LigaSure Alone Sufficient for the Closure of the Appendix Stump?

Is LigaSure Alone Sufficient for the Closure of the Appendix Stump?

Evaluation of the Appropriate LigaSure™ Device to Transect the Appendix—A Comparison between 5 mm and 10 mm Laparoscopic Devices in an Ex Vivo Trial

Closure of the appendix stump with two different suture materials in laparoscopic appendectomy in children

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