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Sutureless Appendectomy by Using Harmonic Scalpel: Is It Possible?

Vipin Gupta1, Shailendra Pal Singh1, Somendra Pal Singh1

  • 1Department of Surgery, UP University of Medical Sciences, Etawah, India.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|February 19, 2020
PubMed
Summary
This summary is machine-generated.

Harmonic scalpel (HS) is a safe and effective tool for sealing the appendix base during laparoscopic appendectomy. This method significantly reduces operative time compared to traditional endoloop techniques, with comparable complication rates.

Keywords:
appendectomyappendicitisharmonic scalpellaparoscopic appendectomy

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Gastrointestinal Surgery

Background:

  • Laparoscopic appendectomy is a standard surgical procedure.
  • Various methods exist for securing the appendix base, including sutures, LigaSure, endoloops, and hem-o-lok clips.
  • The harmonic scalpel (HS) offers a potential alternative for sealing the appendix base.

Purpose of the Study:

  • To evaluate the efficacy and safety of using the harmonic scalpel (HS) for sealing the appendix base during laparoscopic appendectomy.
  • To compare operative times and complication rates between HS sealing and endoloop ligation.

Main Methods:

  • A comparative study involving 210 patients undergoing laparoscopic appendectomy.
  • Patients were divided into two groups: Group 1 (endoloop) and Group 2 (HS sealing).
  • Data collected included patient demographics, operative time, and postoperative complications over a 3-month follow-up period.

Main Results:

  • A total of 102 patients were in the endoloop group and 108 in the HS group.
  • Mean operative time was significantly shorter in the HS group (28.46 ± 7.19 minutes) compared to the endoloop group (43.34 ± 6.7 minutes) (P < .0001).
  • Postoperative ileus and surgical site infection rates were comparable between the two groups (P > .05).

Conclusions:

  • The use of harmonic scalpel for laparoscopic appendectomy is feasible and safe.
  • HS sealing demonstrates comparable efficacy to traditional methods with reduced operative time.
  • Further multi-center studies are recommended to validate these findings.