Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive Care2219-40612587-6554Eco-Vector58310.17816/psaic583Research ArticleUnligature method of laparoscopic appendectomy in childrenSvarichVyacheslav G.<p>Dr. Sci. (Med.), Head of the surgical department; Professor of the department of surgery of the medical institute</p>svarich61@mail.ruhttps://orcid.org/0000-0002-0126-3190PerevozchikovEvgeniy G.<p>physician surgical department</p>doctor-zhenya@yandex.ruKagantsovIlya M.<p>Dr. Sci. (Med.), Head of the uronefrological department; Professor of the department of surgery of the medical institute</p>ilkagan@rambler.ruhttps://orcid.org/0000-0002-3957-1615Republican children’s Clinical HospitalPitirim Sorokin Syktyvkar State University2111202010153581502202008092020Copyright © 2020, Svarich V.G., Perevozchikov E.G., Kagantsov I.M.2020<p><strong>Aim.</strong> On the basis of the accumulated clinical material to show the possibility of a ligature-free method of laparoscopic appendectomy in children.</p>
<p><strong>Materials and methods</strong>. From 2000 to 2019, 2044 children with acute appendicitis were treated in the surgical department of the Republican childrens clinical hospital in Syktyvkar. Of these, 651 patients had an open appendectomy with treatment of the stump of the vermiform process by the submersible method, 1363 children had a laparoscopic appendectomy with ligature treatment of the stump of the process, and 32 patients had their first non-ligature laparoscopic appendectomy with the intersection of the vermiform process with the Ligasure device.</p>
<p><strong>Results</strong>. On average, surgery for ligature-free laparoscopic appendectomy lasted 7 3 minutes less than for laparoscopic appendectomy using the ligature method for treating the stump of the worm-like process. Experimentally, it was found that this method of appendectomy should not be used when the thickness of the worm-like process is more than 1.5 cm, with pronounced inflammatory infiltration of the caecum dome and perforation at the base of the process. With ligature-free appendectomy, the operation time was reduced. In the period from 1 to 6 months, there were no intra-abdominal postoperative complications associated with the new method of surgery.</p>
<p><strong>Conclusion</strong>. Ligar-free laparoscopic appendectomy in children using modern high-energy platforms with a digital assessment of the degree of tissue coagulation readiness made it possible to avoid intraoperative and postoperative complications, simplify the technique of its implementation, and reduce the time of surgery.</p>appendicitisappendectomylaparoscopic methodligature-free methodbrewing of the vermiform processаппендицитаппендэктомиялапароскопический способбезлигатурный способзаваривание червеобразного отростка[Исаков Ю.Ф., Степанов Э.А., Дронов А.Ф. Острый аппендицит в детском возрасте. — М.: Медицина, 1980. [Isakov YuF, Stepanov EA, Dronov AF. Ostryj appendicit v detskom vozraste. Moscow, Medicine, 1980. (In Russ.)]][Баиров Г.А. Срочная хирургия детей: Руководство для врачей — СПб.: Питер, 1997. — 463 c. [Bairov GA. Srochnaya hirurgiya detej: Rukovodstvo dlya vrachej. Saint Petersburg, 1997. 463 p. (In Russ.)]][Атлас детской оперативной хирургии / под ред. П. 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