Securing Mesoappendix during Laparoscopic Appendicectomy: Ligation vs. Ligasure

Abstract

Background: Securing the mesoappendix during appendectomy is a crucial step in this procedure. The current study aimed to evaluate the perioperative outcomes of intracorporeal ligation versus Ligasure in securing the mesoappendix during laparoscopic appendicectomy (LA). Patients and Methods: A prospective randomized comparative study was carried out in a tertiary care hospital. Patients who had laparoscopic appendectomy for acute appendicitis between January 2021 and January 2024 were included in this study. Patients were allocated to one of two groups. Group I: the mesoappendix was secured by intracorporeal suture ligation. 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 groups regarding 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 min in group L (statistically significant difference P≤0.05 ). None of the patients required conversion to an open surgery. The duration 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 in group 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 the mesoappendix. However, intracorporeal ligation takes a longer time, which could be improved with training, it is cost-effective, safe, and suitable when energy-sealing devices are not available or in low-resource facilities.