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.

Keywords

• Appendectomy
• Cautery
• Laparoscopy
• Mesoappendix
• Monopolar