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Original Article

PAFMJ. 2015; 65(0): S245-S248


COMPARISON OF HARMONIC SCALPEL WITH MONOPOLAR DIATHERMY IN DISSECTION OF GALL BLADDER FROM LIVER BED IN TERMS OF MEAN OPERATIVE TIME AND FREQUENCY OF GALL BLADDER PERFORATION IN LAPAROSCOPIC CHOLECYSTECTOMY

Muhammad Rehan Saleem, Javed Iqbal Niazi, Omer Bin Abdul Aziz, Taseer Ibrahim, Babar Shamim, Mudassar Abbas Zaidi.

Abstract
Objective: The objective of the study was to compare the harmonic scalpel with monopolar diathermy in dissection of Gall Bladder from liver bed in terms of mean operative time and frequency of gall bladder perforation in Laparoscopic Cholecystectomy (LC).
Study Design: Randomized controlled trial.
Place and Duration of Study: Combined Military Hospital, Multan from 11thJan 2012 to 10th Jul 2012.
Material and Methods: A total of 74 diagnosed patients of cholelithiasis undergoing LC electively fulfilling the inclusion criteria were included in the study, after taking written informed consent and approval of hospital ethics committee. They were randomly divided into two equal groups A" and "B" of thirty seven each using computer generated tables of random numbers. Patient in Group "A" underwent LC by using harmonic scalpel for dissection of gallbladder from liver bed. In Group "B", monopolar diathermy was used for the dissection of gallbladder from its bed.
Results: A significantly higher frequency of gallbladder perforation (21.6% vs. 8.1%) and more time consumption (52.27 min vs. 45.7 min) was seen in LC by using monopolar diathermy as compared to harmonic scalpel.
Conclusion: Use of harmonic scalpel is safer in LC to avoid per operative gallbladder perforation and to complete the procedure in less time as compared to monopolar diathermy.

Key words: Gallstones, Gallbladder perforation, Harmonic scalpel, Laparoscopic cholecystectomy, Monopolar diathermy.



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