Closure of apendical stump by using electrothermal bipolar vessel sealing systems in rabbits

Appendectomy is a treatment method which is prefered for many diseases of appendix, acute appendicitis firstly. One of the most frequent reason which brings the patient with acute abdominal pain to emergency service is acute appendicitis. This situation makes appendectomy one of the most frequently executed urgent surgery intervention at the general surgery departments of the hospitals. Open appendectomy has been executed as a treatment which provides quite positive results for more than a hundred years. Advantages of laparoscopy such as more rapidly wound healing, decreasing the postoperative pain, decreasing duration of stay at the hospital and providing better cosmetic results make laparoscopic minimally invasive surgery techniques more common and mostly prefered for the last ten years especially. Although long operation duration because of the laparoscopic procedures at the early years was an important disadvantage, this disadventage disappears in gaining experiences. But laparoscopic appendectomy couldn't become the golden standart for the appendical operations.Thermal energy systems have been using for purpose of hemostasis and dissection at many departures of surgery. Electrothermal vessel sealing system is a hemostatic device which is in use recently and is improved for abdominal surgery primary. This system denatures and adhering the collagen and elastin fibers in the vessels or the other tissues by heat, so it creates plugs and provides hemostasis. Electrothermal vessel sealing system can be used in secure to seal vessels up to 7 milimetres diameter.This experimental study has been made for purpose of examining the reliability and efficiency of electrothermal vessel sealing systems, which possibly can be in use for other tissues excepting vessels, in closure of appendical stump by assessing tissue healing.In the experiment, 32 albino rabbits of New Zeland variant which their ages are between 1-2 years old, their weights are between 2-5 kilograms, including both sexes has been used. Four groups which each one includes eight rabbits has been made up. The appendical stump of first two groups was closed with silk sutures. The appendical stump of last two groups was closed with Ligasure which is a electrothermal vessel sealing system. One of the groups which is closed their appendical stump with silk suture and one of the groups which is closed their appendical stump with Ligasure reoperated in 3th day, the other two groups reoperated in 7th day and samples were drawn in order to assess early and late period tissue healing.Biochemical and immunhistochemical tests has been applied on drawn samples in order to assess wound healing. Immunreactivities of the tissues has been assessed by collagen 1, IL-1ß, FGF-2 and TGF-ß antibodies for immunhistochemical tests. Tissue hydroxyproline levels has been measured biochemically.In assessing findings; it is observed that there is no statistical differance between the groups at the early period, but at the late period inflammatory response of the Ligasure group is more. It is identified that at the late period the levels of hydroxyproline of the Ligasure group is more than the silk group so it is observed that wound healing of the Ligasure group is better than the other group. There was no difference about TGF-beta levels between groups at the late stage and it was observed that fibrosis on healed wounds was at equal levels.In conclusion, it has been experienced that the electrothermal vessel sealing systems is an alternative and reliable method to close the appendical stump. On the other hand more experimental studies have been needing to execute this technique on humans.