Safety and Efficacy of Monopolar Cautery in Dissection of Mesoappendix in Laparoscopic Appendectomy in Western Nepal, a Multicentered Cross-Sectional Retrospective Study

Abstract

Introduction: Different instruments are being used for appendiceal mesentery dissection in laparoscopic appendectomy. The effectiveness and versatility of monopolar cautery for the same makes it a commonly used option. This study aims to observe the safety and efficacy of monopolar cautery in laparoscopic appendectomy for the dissection of mesoappendix.

Methods: 424 cases who underwent laparoscopic appendectomy from November 2018 to April 2020 using monopolar cautery for mesoappendix dissection were included in this multi-centered cross-sectional retrospective study. The operating time, intra and post-operative complications and length of hospital stay were evaluated. Measures of central tendency were performed for data analysis.  

Results: Acute appendicitis was the common indication (96.7%) for the laparoscopic surgery, with 99.1% success rate with a male to female ratio of 1.17:1 and mean age of 21.48+14.80 years. The median operating time and length of hospital stay were 30 mins (range: 15–130 mins) and 3 days (range: 1-15 days), respectively. Moderate intra-operative bleeding was noted in 0.5%. Post-operative complications of wound infection (3.4%) and prolonged ileus (1.7%) were noted.

Conclusion: Use of monopolar cautery for dissection of mesoappendix in laparoscopic appendectomy is still safe and efficient even with the advent of newer and more expensive instruments in the present world.