Does the Use of Newer Technology to Divide the Mesoappendix Result in Less Bleeding? A Retrospective Analysis

Matthew P. Doepker, Justin L. Gregg, Giacomo Meeker, Bryan Ellis, Kevin Grannan

Abstract


Background: Various methods have been used to seal and divide the mesoappendix, such as endoscopic linear cutting staples, the Harmonic Scalpel and even monopolar coagulation. The goal of this study was to determine whether using any of these energy sources versus any non-energy source would be superior in terms of post-operative complications (primarily bleeding), hospital length of stay and cost.

Methods: This study included all patients who underwent laparoscopic appendectomy for acute appendicitis between January 2007 and April 2010 at a community hospital system with two large hospitals. The primary outcomes measured were bleeding, post-operative anemia, blood transfusion requirements, length of stay and cost.

Results: Laparoscopic appendectomy was performed on 838 patients. An energy source was used on 503 patients and a non-energy source was used on 335 patients. No statistically significant differences were found regarding post-operative complications or length of stay. There was, however, a financial difference found, in that it was much less expensive to use a non-energy source versus an energy source when handling and controlling the mesoappendix.

Conclusions: Using a non-energy source is as safe as an energy source for dividing and sealing of the mesoappendix. This study supports the use of a non-energy source as a comparable method when compared to a non-energy source, with no difference in main outcomes.




J Curr Surg. 2014;4(1):6-9
doi: http://dx.doi.org/10.14740/jcs198w


Keywords


Laparoscopic appendectomy; Energy source; Non-energy source; Bleeding; Division of mesoappendix; Post-operative complications; Length of stay; Cost

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