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Scalpel Superior to Clip, Cautery in Single-port Laparoscopic Cholecystectomy
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Compared with the conventional clip and cautery technique, use of shears was superior in single-port laparoscopic cholecystectomy, according to data presented at the Society of American Gastrointestinal and Endoscopic Surgeons 2015 Annual Meeting.
Investigators performed a prospective randomized controlled trial to compare surgical outcomes of single-port laparoscopic cholecystectomy performed by shears (Harmonic) vs. the conventional clip and cautery technique. Of 120 patients with symptomatic uncomplicated gallstone disease (84.2% female; median age, 38 years), half were assigned to undergo surgery with the Harmonic scalpel and the other half with the clip and cautery technique.
Median dissection time associated with use of Harmonic shears was 43.5 minutes vs. 72.5 minutes with clip and cautery (P = .001) and median total operative time was 71 minutes vs. 104 minutes, respectively (P = .001). Gallbladder perforation was lower in the Harmonic shears group (15% vs. 28.3%), but the difference was not statistically significant. Postoperative complications were comparable (8.3% vs. 10%), and port-site infection occurred in 3.3% of the clip and cautery group compared with 5% of the Harmonic scalpel group. No bile leaks or bile duct injuries occurred, and during a median follow-up of 11 months, one patient in each group developed a port-site hernia.
The researchers concluded that using Harmonic shears was superior to clip and cautery based on its association with shorter operative time. – by Adam Leitenberger
Reference:
Bessa S. Abstract S008. Presented at: Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting; April 15-18, 2015, Nashville.
Disclosure: Relevant financial disclosures were not provided.