LAPAROSCOPIC APPENDECTOMY BY ULTRASONICALLY ACTIVATED SCALPEL: A PROSPECTIVE STUDY

Aim: Laparoscopic appendectomy (LA) is increasingly being used in treating acute appendicitis. New instruments such ultrasonically activated scalpel as have been introduced for most laparoscopic procedures as a hemostatic too. This study was done to evaluate the feasibility and effectiveness of ultrasonically activated scalpel during LA, as the role of this instrument in LA remains to be defined. Patients and Methods: Between January 2004 and April 2005 fifty patients with clinical diagnosis of acute appendicitis were included in this study. Once the diagnosis of acute appendicitis was established, laparoscopic appendectomy was performed using the ultrasonically activated scalpel for coagulation and cutting of the mesoappendix. Results: The mean operative time was 45.6 minutes±11.6. In one patient conversion to open appendectomy was needed. There were no complications related to the ultrasonically activated scalpel for control of the vascular pedicle. No electro surgical coagulation, clips, loops or endostapler were used in any patient to control the mesoappendix. Conclusion: Use of ultrasonically activated scalpel during laparoscopic appendectomy is feasible. It makes dissection of the appendix easier, helping to reduce the mean operative time