Laparoscopic appendectomy: A series of cases utilizing laparosonic coagulating shears as compared to endo-GIA and endoshears

OBJECTIVE: To report a series of laparoscopic appendectomies utilizing laparosonic coagulating shears (LCS) (harmonic scalpel). STUDY DESIGN: We conducted a retrospective chart review, of all patients who underwent laparoscopic appendectomy at Walter Reed Army Medical Center between January 1, 1996, and December 31, 2001. Procedures were included if only 1 instrument was utilized for transection of the appendix: endoshears, endo-GIA (Tyco U.S. Surgical, Norwalk, Connecticut) or LCS. Procedures on ruptured appendixes and emergency procedures were excluded. Outcome variables of interest included operative time, estimated blood loss, length of hospital stay and complications. RESULTS: Mean estimated blood loss, mean operative times and hospital stay were consistent with those of other techniques of laparoscopic appendectomy. LCS was used more frequently for appendectomy performed at the time of another procedure than were endo-GIA and endoshears. There were no complications in the harmonic scalpel laparoscopic appendectomy series. CONCLUSION: This series demonstrates that laparoscopic appendectomy with LCS has low morbidity and is as efficacious as other methods of laparoscopic appendectomy.