Use of the ultrasonic dissecting scalpel in laparoscopic cholecystectomy

Power, Colm; Maguire, Donal; McAnena, O. J.; Calleary, J.

doi:10.1007/s004640000034

Cited by 47 publications

(37 citation statements)

References 18 publications

(35 reference statements)

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“…The characteristics of the ultrasonically activated shears described previously make the use of this instrument in laparoscopic procedures promising in terms of ergonomics and safety. There have been other reports on the use of ultrasonically activated devices during LC [32,37,41], in which the harmonic scalpel or shears were employed for dissection only or for dividing the cystic artery. In 1999, the use of ultrasonically activated shears for both dissection and closure-division of the cystic duct and artery was first reported [21].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy by ultrasonic dissection without cystic duct and artery ligature

et al. 2003

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No significant difference was found in both patient groups regarding postoperative mortality and complications, biliary complications, and especially cystic duct leaks. A retrospective comparison of literature data showed that use of ultrasonic dissection during LC seems to reduce the risk of BDI. Nevertheless, a learning curve in the use of ultrasonic-activated devices is required: a significant differences in postoperative major complications and biliary complications between the expert and the surgeon-in-training subgroups was shown. Furthermore, ultrasonic scissors misuse may cause bowel injuries in patients with severe adhesions, and this could represent a possible limitation for surgical safety.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy by ultrasonic dissection without cystic duct and artery ligature

et al. 2003

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“…[4][5][6] Ultrasonic dissection generates less thermal injury, produces a smaller zone of tissue damage and more precise dissection, and has been suggested as an alternative to monopolar electrocautery in laparoscopic cholecystectomy. [7][8][9] The incidence of gallbladder perforation also has been reported to be low with ultrasonic dissection compared to monopolar electrocautery during laparoscopic cholecystectomy. [7][8][9][10][11] Ultrasonic dissection of the gallbladder bed during laparoscopic cholecystectomy has the potential to improve the quality of surgery by decreasing the incidence of gallbladder perforation and its intraoperative consequences.…”

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confidence: 99%

“…[7][8][9] The incidence of gallbladder perforation also has been reported to be low with ultrasonic dissection compared to monopolar electrocautery during laparoscopic cholecystectomy. [7][8][9][10][11] Ultrasonic dissection of the gallbladder bed during laparoscopic cholecystectomy has the potential to improve the quality of surgery by decreasing the incidence of gallbladder perforation and its intraoperative consequences. The present study was designed and conducted to observe the effect of ultrasonic dissection in laparoscopic cholecystectomy and to determine the incidence of gallbladder perforation and its intraoperative consequences.…”

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Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial

et al. 2012

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RESEARCH • RECHERCHEMonopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial Background: Ultrasonic dissection has been suggested as an alternative to monopolar electrocautery in laparoscopic cholecystectomy because it generates less tissue damage and may have a lower incidence of gallbladder perforation. We compared the 2 methods to determine the incidence of gallbladder perforation and its intraoperative consequences. Methods:We conducted a prospective randomized controlled trial between July 2008 and December 2009 involving adult patients with symptomatic gall stone disease who were eligible for laparoscopic cholecystectomy. Patients were randomly assigned before administration of anesthesia to electrocautery or ultrasonic dissection. Both groups were compared for incidence of gallbladder perforation during dissection, bile leak, stones spillage, lens cleaning, duration of surgery and estimation of risk of gallbladder in the presence of complicating factors. Results:We included 60 adult patients in our study. The groups were comparable with respect to demographic characteristics, symptomatology, comorbidities, previous abdominal surgeries, preoperative ultrasonography findings and intraoperative complications. The overall incidence of gallbladder perforation was 28.3% (40.0% in the electrocautery v. 16.7% in the ultrasonic dissection group, p = 0.045). Bile leak occurred in 40.0% of patients in the electrocautery group and 16.7% of patients in ultrasonic group (p = 0.045). Lens cleaning time (p = 0.015) and duration of surgery (p = 0.001) were longer in the electrocautery than the ultrasonic dissection group. There was no statistical difference in stone spillage between the groups (p = 0.62). Conclusion:Ultrasonic dissection is safe and effective, and it improves the operative course of laparoscopic cholecystectomy by reducing the incidence of gallbladder perforation.

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“…It is held to facilitate a faster dissection, provide an enhanced vessel sealing capacity, and result in less lateral thermal tissue damage [10,[13][14][15][16].…”

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confidence: 99%

Improved outcome after laparoscopic cholecystectomy with ultrasonic dissection: a randomized multicenter trial

et al. 2009

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Use of the ultrasonic dissecting scalpel in laparoscopic cholecystectomy

Cited by 47 publications

References 18 publications

Laparoscopic cholecystectomy by ultrasonic dissection without cystic duct and artery ligature

Laparoscopic cholecystectomy by ultrasonic dissection without cystic duct and artery ligature

Monopolar electrocautery versus ultrasonic dissection of the gallbladder from the gallbladder bed in laparoscopic cholecystectomy: a randomized controlled trial

Improved outcome after laparoscopic cholecystectomy with ultrasonic dissection: a randomized multicenter trial

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