Dissection of mesoappendix in laparoscopic appendectomy: A comparison of monopolar cautery and bipolar vessel sealing system

Abstract

Aim: Various technique and different instruments like endoscopic stapler, endoscopic clip, monopolar cautery, harmonic scalpel, and bipolar vessel sealer can be used in the dissection of appendix mesentery when performing laparoscopic appendectomy. The aim of this study is to evaluate the effects of using monopolar cautery and bipolar vascular sealing instruments in the dissection of mesentery of appendix on the duration of the operation of pediatric patients. Materials and methods: Sixty three patients, operated laparoscopically for acute appendicitis in between June 2008 and June 2009 at the Pediatric Surgery Clinic of Di{dotless}şkapi{dotless} Children's Hospital, are evaluated retrospectively. Monopolar cautery was used in 25 patients and bipolar vessel sealer was used in 38 patients. No intraoperative or postoperative complication was seen in any of the patients. None of the patients required conversion to open surgery due to dissection problems of the appendiceal mesentery. Results: The mean duration of operation was 51.08 min in the monopolar cautery group whereas 36, 68 minutes in the bipolar vessel sealing system group. Conclusion: In children, comparing to monopolar cautery, bipolar vessel sealer can be used effectively and safely in the dissection and hemostasis of appendiceal mesentery and is definitely an effective system in decreasing the operation time. © TÜBİTAK.