Laparoscopic Appendicectomy: Comparison of Monopolar Cautery and Harmonic Scalpel in Ligation of Mesoappendix
Background: To compare monopolar diathermy with harmonic scalpel in the ligation of mesoappendix while doing laparoscopic appendicectomy in terms of mean operative time and per-operative bleed.
Methods: In this randomized controlled trial patients between 15 to 50 years who were planned for laparoscopic appendicectomy were included. Patients were divided into two groups. Group 1 was operated using monopolar diathermy and in Group 2 harmonic scalpel was used for dissection of mesoappendix. Total time required to cauterize the mesoappendix using the monopolar diathermy or harmonic scalpel was measured in minutes. Per operative bleed was visualized at the time of cauterizing the mesoappendix and was estimated by the gauzes used for mopping when the field became obscure. Gauzez were placed on physical balance and weighed.
Results: Out of 60 patients enrolled for the study, 30 were put in group 1 and 30 in group 2. Comparison of mean operative time in both groups was calculated as 17.7+3.35 in Group-1 and 17.6+3.28 in Group-2, p value was calculated as 0.90 showing insignificant difference. Comparison of mean blood loss in both groups was calculated as 3.40+2.45 in Group-1 and 3.30+2.37 in Group-2, p value was calculated as 0.87, showing insignificant difference.
Conclusion: Monopolar cautery is equally effective in ligation of mesoappendix as compared to harmonic scalpel while performing laparoscopic appendicectomy.