Laparoscopic Cholecystectomy with Harmonic Scalpel

Abstract

Objective: To compare results in terms of thermal injuries and biliary complications with use of monopolar hook and ultrasonic harmonic scalpel Inlaparoscopic cholecystectomy.

Study Design: Quasi-experimental study

Place and Duration of Study: This study was conducted at Surgical Unit I and III, Nishtar Hospital Multan from November 2011 to July 2012.

Materials and Methods: During a 9 months period, in a personal series of 95 consecutive patients, the Harmonic scalpel was used as the sole instrument for both division and dissection of the cystic artery and duct. The average length of inpatient stay, procedure duration, and complications were compared with the data of a homogenous control group of patients who were treated using monopolarelectrosurgery and clips. Measurements of the percentage were made using SPSS 15.Statistical significance level was at p <0.001

Results: Neither major complications nor bile duct injuries were detected in either group, and no statistically significant difference was found between the groups in terms of the incidence of postoperative complications. However, the mean operative time was significantly shorter in patients treated with the Harmonic scalpel.

Conclusion: The Harmonic scalpel is not only a safe and effective instrument but also a reliable substitute for clips because it provides complete hemobiliary stasis. Even if the study revealed no differences with regard to postoperative complications, the Harmonic scalpel represents a viable alternative because of the shorter operation time and cost savings that are inherent in a procedure using it as a single instrument.