Issue: 2025, Vol. 30, No. 2

A. V. Gusev, A. Yu. Soloviev, K. A. Manukyan, E. L. Shumarina, D. A. Bobrov

LIGATION-FREE METHOD OF LAPAROSCOPIC APPENDECTOMY USING THE LIGASURE ATLAS DEVICE

Keywords

vermiform appendix, stump, mesentery of vermiform appendix, appendicitis, laparoscopic appendectomy, classical appendectomy, ligature-free appendectomy, LigaSure Atlas

Abstarct

Appendectomy is one of the most common surgical interventions in emergency surgery. Laparoscopic appendectomy (LA) is the operation of choice at present according to clinical guidelines, its important step being the treatment of the appendiceal stump (AS). The development of technology helped improve and simplify this stage of the operation. Publications of successful AS treatment with different types of energy are available in domestic and foreign literature. The method of ligature-free laparoscopic appendectomy (LLA) using the LigaSure Atlas device may surpass LA in the future in terms of efficiency and lack of complications. Objective – to comparatively analyse the results of laparoscopic techniques for the AS treatment and to identify the LLA advantages with using LigaSure Atlas. Material and Methods. The medical records of patients with acute appendicitis (K35) operated in city clinical hospital No. 7 of Ivanovo in the period from 2019 to 2022 were analysed. LA was performed in 282 patients (135 men, 147 women) aged 18 to 80 years old, mean age being 33.00 [24.00; 43.75]. Patients were divided into two groups: those underwent LA using the LigaSure device (main group) (total 136 operations in 61 males and 75 females, average age 33.00 [25.00; 41.00]), and patients who underwent LA with AS treatment by other methods (total 146 operations in 74 males and 72 females, mean age 33.00 [23.25; 45.00]) (comparison group). Results and Discussion. By calculating the Student’s t-criterion, the total surgical LLA intervention with LigaSure device lasted 15 minutes less than in LA with AS treatment by other methods. The stabilisation of the body temperature and the reduction of leukocyte count to normal values in the general blood analysis occurred one day earlier in those operated with the new method. The time of hospital stay was the same for both groups, and averaged 5 days. The histological examination of the removed vermiform appendices in most cases revealed phlegmonous appendicitis. The incidence of postoperative complications in the patients of the main group was 1.98 % less than in the comparison group. Conclusion. The LLA with LigaSure Atlas device is superior to other methods of the AS treatment. The latter makes it possible to apply the described operative technique in medical practice.