Use of Harmonic Scalpel (clipless) versus Conventional Laparoscopic Cholecystectomy (titanium clips)  A prospective study

Dr Ankush kaul; Dr Madhu Lata Ran; Dr Bikramjit Singh Sodhi

Volume : VI, Issue : IX, September - 2016

Use of Harmonic Scalpel (clipless) versus Conventional Laparoscopic Cholecystectomy (titanium clips) A prospective study

Dr Ankush Kaul, Dr Madhu Lata Ran, Dr Bikramjit Singh Sodhi

Abstract :

Aims and Objective–This study was conducted To evaluate the use of Harmonic scalpel as a safe, feasible alternative to use of titanium clips for cystic duct occlusion and to compare post operative outcome of patients in whom laparoscopic cholecystectomy was done by clips with those in whom Harmonic scalpel was used. Material and Method This study is randomised controlled prospective study conducted in the Department of Surgery, GMC, Jammu over a period of one year w.e.f 1st November 2014 to 31st October 2015 on 100 patients suffering from cholelithiasis .The patients were equally divided in two groups of 50 patients each after matching parameters like age group and comorbid condition. In one group of patients undergoing laparoscopic cholecystectomy, cystic duct was occluded with clips and in other group harmonic scalpels were used to occlude cystic duct. Inclusion criteria – All patients undergoing elective cholecystectomy for various reasons and Wall thickness of gallbladder less than 6 mm as shown by ultrasound preoperatively with normal biliary passages and normal cystic duct diameter and length. Exclusion criteria – • Acute Cholecystitis • Patients above 80 yrs of age • Patients having history of upper abdomen lapratomy. • Patient with wide, short, abnormal cystic duct , dilated cbd choledocholithiasis , mirrizi syndrome assessed intra operatively. • Pregnant females Conclusion: Results of this study demonstrate that cystic duct occlusion with harmonic scalpel as a safe, effective , quicker alternative to clips.