Securing Mesoappendix during Laparoscopic Appendicectomy: Ligation vs. Ligasure

Abstract

Background: Securing the mesoappendix during appendectomy is a crucial step in this procedure. The current studyaimed to evaluate the perioperative outcomes of intracorporeal ligation versus Ligasure in securing the mesoappendixduring laparoscopic appendicectomy (LA).Patients and Methods: A prospective randomized comparative study was carried out in a tertiary care hospital. Patientswho had laparoscopic appendectomy for acute appendicitis between January 2021 and January 2024 were included inthis study. Patients were allocated to one of two groups. Group I: the mesoappendix was secured by intracorporeal sutureligation. Group L: the mesoappendix was secured by LigaSure. Demographic and perioperative data were collected,tabulated, and analyzed by SPSS 23.Results: A total of 100 patients underwent LA. No statistically significant difference was found between the two groupsregarding age, sex ratio, or BMI. The technique duration was 8.9±3.5 min in group I, while the duration was 4.9±2.3 minin group L (statistically significant difference P≤0.05). None of the patients required conversion to an open surgery. Theduration of postoperative hospital stay was 12.1±2 h for group I, and 11.1±8 h for group L (P>0.05). One (2%) patient ingroup I had a postoperative right iliac fossa-infected hematoma. In group L, there was no postoperative complications.Conclusion: In LA, the incidence of perioperative complications is not affected by the method used for securing themesoappendix. However, intracorporeal ligation takes a longer time, which could be improved with training, it is costeffective, safe, and suitable when energy-sealing devices are not available or in low-resource facilities.