Clipped vs Clipless Laparoscopic Cholecystectomy using the Ultrasonically Activated (Harmonic) Scalpel

Abdelhady, Mohammed Hamdy; Salama, Asaad F

doi:10.5005/jp-journals-10033-1295

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…A significant reduction in LOS was observed with Harmonic devices across eight RCTs including one ABP device and seven conventional technique comparators. Cholecystectomy [ 40 ] and thyroidectomy [ 53 , 56 , 61 , 63 , 64 , 76 ] RCTs demonstrated significantly shorter LOS for Harmonic devices compared to conventional techniques. Harmonic also demonstrated significantly reduced LOS compared to ABP devices for thyroidectomy [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

An umbrella review of the surgical performance of Harmonic ultrasonic devices and impact on patient outcomes

et al. 2023

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Background For thirty years, the Harmonic scalpel has been used for precise dissection, sealing and transection. There are numerous meta-analyses on individual surgical procedures with Harmonic, but no overarching review covering all the areas. This umbrella review seeks to summarize the clinical results from the use of Harmonic across surgical fields and broadly quantify its effects on patient outcomes. Methods MEDLINE, EMBASE, and Cochrane Databases were searched for meta-analyses (MAs) of randomized controlled trials (RCTs) comparing Harmonic devices to conventional techniques or advanced bipolar (ABP) devices. For each procedure type, the most comprehensive MAs were evaluated. RCTs not already analysed in a MA were also included. Operating time, length of stay, intraoperative blood loss, drainage volume, pain, and overall complications were evaluated, and the methodological quality and certainty of evidence were assessed. Results Twenty-four systematic literature reviews were identified on colectomy, hemorrhoidectomy, gastrectomy, mastectomy, flap harvesting, cholecystectomy, thyroidectomy, tonsillectomy, and neck dissection. There were also 83 RCTs included. In every MA evaluated, Harmonic devices were associated with either statistically significant or numerical improvements in every outcome compared with conventional techniques; most MAs reported a reduction in operating time of ≥ 25 min. Harmonic versus ABP device MAs in colectomy and thyroidectomy showed no significant differences in outcomes. Conclusion Across surgical procedures, Harmonic devices demonstrated improved patient outcomes for operating time, length of stay, intraoperative bleeding, drainage volume, pain, and overall complications compared to conventional techniques. Additional studies are required to assess differences between Harmonic and ABP devices.

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Section: Resultsmentioning

confidence: 99%

An umbrella review of the surgical performance of Harmonic ultrasonic devices and impact on patient outcomes

et al. 2023

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“…Wound infections commonly occur in open surgeries. By reducing the conversion rate, HSC reduces the duration of hospital stay of the patients [3,9,17].…”

Section: Hsc and Surgical Site Infectionsmentioning

confidence: 99%

The Outcomes of the Patients Undergoing Harmonic Scalpel Laparoscopic Cholecystectomy

Kannan¹,

Tara²,

Quadir³

et al. 2021

Cureus

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Laparoscopic cholecystectomy has replaced conventional open cholecystectomy and has become the gold standard surgery for gall bladder pathologies. The harmonic scalpel is one of the instruments used to dissect and coagulate. Most surgeons accept the usage of the harmonic scalpel in laparoscopic cholecystectomy. The other standard method is electrocoagulation by electrocautery. The harmonic scalpel cholecystectomy has several advantages over other methods of laparoscopic cholecystectomy. Electrocoagulation by electrocautery produces smoke which can result in damage to lateral tissues, including the gall bladder. The clips are used along with electrocoagulation to seal cystic duct and cystic artery before dissection. There are various studies about bile leakage in the case of clip application. The harmonic scalpel uses ultrasonic energy to achieve hemostasis without bleeding, dissection, and gallbladder removal from the liver bed during laparoscopic surgery by causing coagulation of proteins. The patient outcome variables such as postoperative pain, duration of hospital stay, postoperative nausea and vomiting, surgical site infections, and other complications have not been compared in review articles. In this review, we collected the information from previously published studies and reviewed the outcomes of patients undergoing harmonic scalpel cholecystectomy. Harmonic scalpel cholecystectomy reduces the duration of hospital stay, duration of operation, intraoperative and postoperative complications, and postoperative pain. Thus the harmonic scalpel can be used instead of other instruments as it has better patient outcomes.

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Clipped vs Clipless Laparoscopic Cholecystectomy using the Ultrasonically Activated (Harmonic) Scalpel

Cited by 2 publications

References 8 publications

An umbrella review of the surgical performance of Harmonic ultrasonic devices and impact on patient outcomes

An umbrella review of the surgical performance of Harmonic ultrasonic devices and impact on patient outcomes

The Outcomes of the Patients Undergoing Harmonic Scalpel Laparoscopic Cholecystectomy

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