Dissection of the appendix with ultrasound-activated scalpel: an experimental study in pediatric laparoscopic appendectomy

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Andreas BartensteinZacharias Zachariou

Abstract

The aim of this study was to examine mechanical, microbiologic, and morphologic changes of the appendicle rim to assess if it is appropriate to dissect the appendix with the ultrasound-activated scalpel (UAS) during laparoscopic appendectomy. After laparoscopic resection of the appendix, using conventional Roeder slings, we investigated 50 appendicle rims with an in vitro procedure. The overall time of dissection of the mesoappendix with UAS was noted. Following removal, the appendix was dissected in vitro with the UAS one cme from the resection rim. Seal-burst pressures were recorded. Bacterial cultures of the UAS-resected rim were compared with those of the scissors resected rim. Tissue changes were quantified histologically with hematoxylin and eosin (HE) stains. The average time to dissect the mesoappendix was 228 seconds (25-900). Bacterial culture growths were less in the UAS-resected probes (7 versus 36 positive probes; (p > 0.01). HE-stained tissues revealed mean histologic changes in the lamina propria muscularis externa of 2 mm depth. The seal-burst pressure levels of the appendicle lumen had a mean of 420 mbar. Seal-burst pressures and depths of histologic changes were not dependent on the different stages of appendi...Continue Reading

References

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Citations

Nov 12, 2013·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Jun Suh Lee, Tae Ho Hong
May 19, 2012·The Surgical Clinics of North America·Victoria K PepperRichard H Pearl
May 14, 2011·Current Opinion in Pediatrics

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BETA
Dissection

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