Total laparoscopic clipless cholecystectomy by harmonic scalpels in patients with gall bladder stones
Introduction: Gallstones are common in western countries. Usually in minimally invasive cholecystectomy, cystic artery and duct both are separately ligated using metallic clips and then divided. Harmonic scalpel is effectual, useful, and secure instrument regarding control of blood loss and dissection especially in laparoscopic procedure for cholecystectomy.
Objective: To delineate outcome of totally clipless laparoscopic cholecystectomy with harmonic scalpels in gall stones disease.
Materials and Method: This research (a retrospective case study) was done at surgical department, Lahore General Hospital, Lahore for 12 months. Total 195 patients fulfilling the above mentioned inclusion criteria were enrolled. Then patients underwent surgery under general anaesthesia. During surgery, operative time, gall bladder perforation and blood loss were noted. Patients were evaluated if conversion to open surgery was required. After surgery, patients were followed-up in OPD for 7 days for assessment of infection.
Results: Mean age of patients was 45.75±14.98 years. Among patients 93(47.7%) were male and 102(52.3%) were female. Mean duration of gall bladder stone was 5.02±0.80 months. Mean time for operation was 50.27±12 minutes. Mean loss of blood was 73.11±20.46 ml respectively. There were 24(12.3%) cases who had perforation. Total 35(17.9%) patients suffered from infection post operatively.
Conclusion: Total laparoscopic clipless cholecystectomy by harmonic scalpels is fully safe and useful technique in surgery for gall bladder stones.
Key words: Total laparoscopic clipless cholecystectomy, harmonic scalpels (HS), gall bladder stones