Efficacy of LigaSure versus Harmonic scalpel US in laparoscopic appendectomy in management of acute appendicitis

Abstract

Introduction: Acute appendicitis is the most common abdominal surgical emergency worldwide, with peak incidence occurring between the second and third decades of life. Appendectomy, performed for over a century, remains the standard treatment.

Aim: Compare the safety and efficacy of laparoscopic appendectomy using LigaSure versus the Harmonic scalpel.

Materials and methods: This prospective comparative observational study was conducted from January 2023 to January 2025 and included 600 patients diagnosed with suspected acute appendicitis at two research centers. Patients were randomized into two equal groups: Group A (n = 300) underwent laparoscopic appendectomy using a Harmonic scalpel, and Group B (n = 300) underwent the procedure using LigaSure.

Results: All 600 procedures were completed laparoscopically without conversion to open surgery. The mean operative time was 27.4 (6.7) minutes (range: 24–49 min) for Group A and 28.1 (7.4) minutes (range: 25–51 min) for Group B. The mean hospital stay was 1.14 (0.53) days for Group A and 1.16 (0.47) days for Group B. No major complications occurred. One minor postoperative complication (fever) was recorded in each group, both of which resolved completely within one week.

Conclusions: Both LigaSure and the Harmonic scalpel are safe and effective for laparoscopic appendectomy in acute appendicitis, resulting in short operative times, minimal postoperative pain, low complication rates, and brief hospital stays.