Laparoscopic Appendectomy Using the LigaSure ® Vessel Sealing Device at the Time of Gynecologic Surgery

Abstract

Abstract

Objective: Despite its many reported advantages, laparoscopic appendectomy has not gained widespread acceptance, perhaps because of prolonged operative time and technical complexity, compared to the open procedure. The objective of this report was to describe the authors experience with using the LigaSure® device for the performance of an appendectomy during laparocopic surgery for gynecologic malignancies. This is the first description in the literature reporting the use of a sealing device across the appendiceal base without a loop or ligature. Design and Methods: All laparoscopic surgeries for gynecologic malignancy since 2004 at the author's center have been prospectively recorded. For appendectomies, the 5-mm LigaSure® was used to divide the mesoappendix and separate the appendix from the cecum. Surgical information, including the duration of surgery, blood loss, and complications, as well as the patients' medical and demographic information, were reviewed and analyzed. Results: Fourteen cases of laparoscopic appendectomy using the LigaSure® vessel sealing device were prospectively collected between 2004 and 2009. The patients' median age was 34 and their median body mass index was 25. The median total operative time was 1.5 hours, and the duration of appendectomy was approximately 5 minutes in each case. Median estimated blood loss was 50 mL per procedure. There were no conversions to laparotomy and no major intraoperative or postoperative complications. Conclusions: Performance of an appendectomy using the LigaSure vessel sealing device to divide both the mesoappendix and the appendiceal base is feasible and appears to be safe for surgery for gynecological malignancy. The applicability of this technique to other surgical settings, including acute appendicitis, needs further investigation. (J GYNECOL SURG 28:188)