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

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