Gupta Vipin, Singh Shailendra Pal, Singh Somendra Pal, Bansal Mradul, Pandey Anand
Department of Surgery, UP University of Medical Sciences, Etawah, India.
Department of Pediatric Surgery, King George's Medical University, Lucknow, India.
J Laparoendosc Adv Surg Tech A. 2020 Apr;30(4):429-432. doi: 10.1089/lap.2019.0782. Epub 2020 Feb 18.
Laparoscopic appendectomy is a commonly performed procedure. The base of appendix is secured by various techniques (suture, LigaSure, endoloop, or hamlock clip). Harmonic scalpel (HS) may be used to seal the base of the appendix. The study was conducted to assess the efficacy of HS in laparoscopic appendectomy for sealing the base of the appendix. The patients were divided into two groups: group 1 in which base was secured by endoloop and group 2 in which base of the appendix was sealed by HS in a stepwise manner. We made a record of patients' age and gender, and operative time. The patients were followed for a period of 3 months from the time of discharge. During the study period of 4.5 years, 102 patients were in group 1 and 108 patients in group 2. Both groups were age and gender matched. Mean operating time for group 1 was 43.34 ± 6.7 minutes and that for group 2 was 28.46 ± 7.19 minutes ( < .0001). Complications included postoperative ileus (group 1 = 8, group 2 = 10) and surgical site infection (group 1 = 4, group 2 = 4, > .05). It appears that use of HS for laparoscopic appendectomy is feasible and safe. Its results appear to be comparable with other methods of laparoscopic appendectomy. Complications are minimal. Further studies at other centers may substantiate our efforts.
腹腔镜阑尾切除术是一种常见的手术。阑尾根部可通过多种技术（缝合、LigaSure、Endoloop或套扎夹）进行固定。可使用超声刀（HS）封闭阑尾根部。本研究旨在评估HS在腹腔镜阑尾切除术中封闭阑尾根部的疗效。患者分为两组：第1组使用Endoloop固定阑尾根部，第2组采用逐步使用HS封闭阑尾根部。我们记录了患者的年龄、性别和手术时间。患者从出院起随访3个月。在4.5年的研究期间，第1组有102例患者，第2组有108例患者。两组在年龄和性别上相匹配。第1组的平均手术时间为43.34±6.7分钟，第2组为28.46±7.19分钟（<0.0001）。并发症包括术后肠梗阻（第1组=8例，第2组=10例）和手术部位感染（第1组=4例，第2组=4例，>0.05）。看来在腹腔镜阑尾切除术中使用HS是可行且安全的。其结果似乎与其他腹腔镜阑尾切除术方法相当。并发症极少。其他中心的进一步研究可能会证实我们的研究成果。
