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Comparative Studies | General Surgery | India | Volume 12 Issue 8, August 2023
Comparative study of Harmonic Scalpel Assisted Clip Less Laparoscopic Cholecystectomy v/s Clipped Laparoscopic Cholecystectomy
Dr. Irshad Ahmad | Dr. Arun Rathore | Dr. Shivam Sharma [9]
Abstract: Objective: To compare both modalities in terms of operative time, no. of times instruments changed, post-operative pain, post-operative drainage, complications and hospital stay (recovery time). To assess and compare the cost-effectiveness of the harmonic scalpel assisted clip less laparoscopic cholecystectomy and clipped laparoscopic cholecystectomy. Methods: The patients were prospectively randomized into two groups- Group-A (study group) - includes all cases that were treated by using harmonic scalpel. Group-B (control group) - includes all cases that were treated by using monopolar electrocautery and titanium clips. Results: Post-operative pain was measured with visual analogue scale (VAS) graded between 110 according to the patient's perception. Mean post-operative pain in study group was 3.88 (range 1 to 8) and in control group was 3.98 (range 1 to 7). Mean operative time in study group was 40.40 min (range 28 to 60 min) and in control group was 49.90 min (range 30 to 70 min). On Statistical analysis, significant difference was found in operative time of both the groups. Mean drainage in study group was 46.83 ml (range 20 to 80 ml) and in control group was 48.16 ml (range 20 to 180 ml). On Statistical analysis no significant difference was found in drainage of both the groups. Conclusion: On the basis of our study we conclude that use of harmonic scalpel for dissection, isolation, sealing and cutting of cystic duct and artery is safe, effective, and without any complication. We recommend use of harmonic ACE for laparoscopic cholecystectomy especially when cystic duct diameter is less than 5 mm.
Keywords: Harmonic scalpel, Clipless laparoscopic cholecystectomy
Edition: Volume 12 Issue 8, August 2023,
Pages: 2150 - 2153