scholarly journals Comparison of laparoscopic cholecystectomy using harmonic scalpel with conventional laparoscopic cholecystectomy in patients of symptomatic gallstones.

2020 ◽  
Vol 27 (10) ◽  
pp. 2050-2055
Author(s):  
Muhammad Asif ◽  
Muhammad Faheem Anwer ◽  
Muhammad Hasan Anwaar ◽  
Shahbaz Ahmad ◽  
Muhammad Kamran ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Conventional Group ◽  
P Value ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Symptomatic Gallstones ◽  
Group B

Objectives: To compare the laparoscopic cholecystectomy using harmonic scalpel with conventional laparoscopic cholecystectomy in patients of symptomatic gallstones in terms of mean operative time and mean intra-operative blood loss. Study Design: Randomized Control trial. Setting: Department of Surgical at Allied Hospital Faisalabad. Period: 6 months Oct 2017 to Mar 2018. Material & Methods: Eighty (80) patients (forty in one group) divided randomly into A (harmonic scalpel group) and B (conventional) group, done under general anesthesia. Total time of operation and blood loss during procedure was noted. Results: Our study showed that mean operative time in Harmonic group (A) was 38.07+5.28 minutes and in Conventional group (B) 63.75+7.62 minutes, (p-value = 0.0001), blood loss in Harmonic group (A) 32.93+8.86ml and 55.53+8.96ml in Conventional group (B), (p-value = 0.0001). Conclusion: It is concluded that the laparoscopic cholecystectomy using harmonic scalpel is significantly better when compared with conventional laparoscopic cholecystectomy in patients of symptomatic gallstones in terms of mean operative time and mean intra-operative blood loss.

Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

2021 ◽  
Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair
Keyword(s):  
Wound Healing ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
The Mean ◽  
Complete Wound Healing ◽  
Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

scholarly journals COMPARATIVE EVALUATION OF COSMETIC OUTCOME BETWEEN CONVENTIONAL LAPAROSCOPIC CHOLECYSTECTOMY & SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Sanjay Kumar ◽  
Ashok Kaundal ◽  
Suneet Katoch
Keyword(s):  
Body Image ◽  
Laparoscopic Cholecystectomy ◽  
Comparative Evaluation ◽  
Single Incision ◽  
The Body ◽  
Cosmetic Outcome ◽  
P Value ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Single Incision Laparoscopic Cholecystectomy

Aim: Comparative analysis of cosmetic outcome between Single Incision Laparoscopic Cholecystectomy and conventional Laparoscopic Cholecystectomy. Method:  Patients suffering from symptomatic cholelithasis were randomly subjected to Single Incision Laparoscopic Cholecystectomy (SILC) and conventional four ports Laparoscopic Cholecystectomy (cLC). Data analyzed included cosmetic outcome, Results: The body image score for SILC group ranged from 30 to 44 with mean score of 40.76 ± 2.773 while that for cLC group ranged from 33 to 42 with mean score of 38.28 ± 1.969. p-value for the comparison stands 0.001 which shows that patients undergoing SILC had better cosmetic perception of their body image compared to cLC group Conclusion: SILC is better cosmetic perception as compare to cLC Keywords: SILC, cLC, Cosmetic outcome

scholarly journals BENEFITS OF EARLY POST-ERCP LAPAROSCOPIC CHOLECYSTECTOMY: A SINGLE CENTRE PROSPECTIVE STUDY

2021 ◽  
Vol 12 (3) ◽  
Author(s):  
Farhan javed ◽  
Saira Saleem ◽  
Ayesha Rehman ◽  
Faiza Wattoo ◽  
Nadia Bano ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Statistical Tests ◽  
P Value ◽  
Cross Sectional ◽  
Increased Risk ◽  
Group A ◽  
Study Population ◽  
Group B

ABSTRACT: BACKGROUND & OBJECTIVE: Laparoscopic cholecystectomy (LC) following Endoscopic retrograde cholangiopancreatography (ERCP) is associated with an increased risk of complications. ERCP is associated with increased incidence of complications during LC. Surgery may be performed in same anesthesia with ERCP or up to 6 weeks later. We aimed to determine the benefits of performing LC within 72hrs of ERCP. METHODOLOGY: After institutional ethical approval this prospective cross-sectional study was performed at Madinah Teaching Hospital Faisalabad from April 2019 to June 2020. By performing convenience sampling, all patients undergoing LC after uneventful ERCP in our hospital were included. Study population was divided based on interval between ERCP and Cholecystectomy; Group-A had LC within 72hrs of ERCP, Group B had LC in same hospital stay after 72hrs and Group-C patients were discharged after ERCP and readmitted for LC. Data was collected using custom designed questionnaire, tabulated using Microsoft Excel 2016 and subjected to statistical tests to compare outcomes. Primary outcome was incidence of complications, while operative time, hospital stay and cost were considered as secondary outcomes. p-value of <0.05 was considered significant. RESULTS: Total 75 patients were included in study, 32 in Group-A, 20 in Group-B and 23 in Group-C. Average age was 44.987 ± 14.819 and study population was predominantly female (86.67%). Complication rate, duration of hospital stay and average cost were less in Group A as compared to other groups (p<0.05). Mean operative time in 3 groups was similar. CONCLUSION: LC within 72hrs after ERCP provides superior results in terms of fewer complications, shorter hospital stays and lesser cost.

scholarly journals COMPARATIVE EVALUATION OF POST-OPERATIVE PAIN BETWEEN CONVENTIONAL LAPAROSCOPIC CHOLECYSTECTOMY & SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Sanjay Kumar ◽  
Ashok Kaundal ◽  
Suneet Katoch
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Score ◽  
Single Incision ◽  
P Value ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Single Incision Laparoscopic Cholecystectomy

AIM: Comparative analysis of post-operative pain between Single Incision Laparoscopic Cholecystectomy and conventional Laparoscopic Cholecystectomy. Method: Patients suffering from symptomatic cholelithasis were randomly subjected to Single Incision Laparoscopic Cholecystectomy (SILC) and conventional four ports Laparoscopic Cholecystectomy (cLC). Data analyzed included duration of surgery, post-operative pain, For assessment of post-operative pain numeric pain scale scoring system was used and pain scoring done at four hours, twelve hours and twenty-four hours post-operatively. Results: The study included fifty patients operated upon from June, 2014 to May, 2014. Twenty-five patients were subjected to SILC and rest of the twenty-five underwent cLC. Pre-operative characteristics of two groups were similar and there was no significant difference between two groups based on age, sex and Body Mass Index. Post-operative pain score was higher for cLC compared to SILC at four, twelve and twenty-four hours post-operatively. The mean pain score at four hours was 4.64 ± 1.89 for SILC versus 7.72 ± 0.84 for cLC (p-value < 0.0001). While the score at twelve and twenty-four hours were 2.96 ± 1.88 and 1.80 ± 1.44 for SILC compared to 5.08 ± 1.15 and 3.80 ± 1.11 for cLC respectively. Conclusion: SILC is superior to cLC compared to post-operative pain as per our study. Keywords: SILC, cLC, post-operative pain

scholarly journals Comparison of single incision laparoscopic cholecystectomy with conventional laparoscopic cholecystectomy using conventional laparoscopic instrument: a prospective observational study

2017 ◽  
Vol 4 (2) ◽  
pp. 514
Author(s):  
Samir Deolekar ◽  
Bhushankumar A. Thakur ◽  
Bhushan Jajoo ◽  
Parnika R. Shinde
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Single Incision ◽  
Operating Time ◽  
Operative Blood Loss ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
The Mean

Background: Laparoscopic surgery is one of the most significant surgical advances of twentieth century. Laparoscopic cholecystectomy is criterion standard for the treatment of benign gall bladder diseases, and it is the most common laparoscopic surgery worldwide. The aim of the study was to compare the intra-operative and post-operative complication, conversion rate and outcome of single incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy on short term follow up.Methods: This prospective analytical observational design study was carried out in Tertiary Health care centre.  As per convenience sampling 60 consecutive patients of cholelithiasis. Data obtained was analyzed and inferences were drawn regarding the outcomes of the SILC in terms of cosmesis, post-operative pain and any other complications and compare the outcomes against the conventional four port laparoscopic cholecystectomy.Results: In our study we found the mean operating time for SILC was 90.5±16.37 minutes, whereas the mean operating time for CLC was 74±17.83 (p = 0.0004). Intra-operative blood loss for SILC and CLC was comparable and statistically insignificant. Pain in the SILC group was found to be significantly low than CLC group (p ≤0.0001).  The median cosmetic scale score for SILC group was 20 with range 13-21 and in conventional laparoscopic cholecystectomy group it was 16 with range 12-18 (p <0.0001).Conclusions: The major advantage of SILC is cosmetic satisfaction, while the disadvantages of SILS are longer operative time. There was no statistically significant difference in the intra-operative blood loss and conversion rate, and complications in both the techniques. Single incision laparoscopic cholecystectomy (SILC) was developed with the aim of reducing the invasiveness of traditional laparoscopy.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY

2018 ◽  
Vol 25 (10) ◽  
pp. 1503-1509
Author(s):  
Mudassar Jabeen ◽  
Bushra Jamil ◽  
Shehzad Amjad Khan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Standard Procedure ◽  
P Value ◽  
Randomized Controlled ◽  
Surgeon Experience ◽  
Widespread Acceptance ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

Introduction: Since the first laparoscopic cholecystectomy (LC) was reportedin 1990, it has widespread acceptance as a standard procedure using four trocars. The fourth(lateral) trocar is used to grasp the fundus of the gall bladder to expose calot`s triangle. Withincreasing surgeon experience, LC has undergone many refinements including reductionin port number and size. Three port LC has been reported to be safe and feasible in manyclinical trials. Objectives: To compare the operative time and of three ports versus four portlaparoscopic cholecystectomy. Study Design: Randomized Controlled Trials. Setting: SurgicalDepartments, Allied & Civil Hospitals Faisalabad. Period: 15-09-2010 to 15-03-2011. Materialand Methods: 132 Patients who underwent elective laparoscopic cholecystectomy wererandomized to undergo either the 4-port. (Group A) or the 3-port LC (group B).66 patients ineach group. Results: Mean Operative time was 25.14±4.19 minutes in group A and 25.35±4.34in group B. (p value-0.774). Mean VAS score at 12th postoperative hour was 5.37±0.993 ingroup A and 4.52±0.986 in group B. (p value <0.0001). Conclusion: Three port Laparoscopiccholecystectomy did not affect, operative time. However it resulted in less early postoperativepain in three port LC.

scholarly journals Comparative Study of Conventional Electrocautery Versus Ultrasonic Dissector in Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 70-73
Author(s):  
Saad Bin Anis ◽  
Pir Muneeb Rehman ◽  
Farhan Ahmad ◽  
Umar Farooq
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Minimal Invasive ◽  
P Value ◽  
Single Incision Laparoscopic Surgery ◽  
Ultrasonic Dissector ◽  
Group A ◽  
Group B

Background: Laparoscopic cholecystectomy (LC) is very commonly performed for removal of gallstones. In routine, ultrasonic devices are used for laparoscopy involving the deeper operating fields, while electrosurgical devices are preferred for LC. However, nowadays both of these devices are used for LC. The objective of this study was to compare the surgical outcomes of ultrasonic dissector over conventional electrocautery in patients planned for LC. Material and Methods: This non-randomized clinical trial was conducted in general surgery unit, Jinnah hospital Lahore. The study duration was 15th January 2015 to 31st December 2016. In group A (n=100), patients were operated through three-port standard laparoscopic cholecystectomy and conventional electrosurgical cautery was used for dissection. While in group B (n=50), patients were operated through single incision laparoscopic surgery (SILS) and Harmonic dissector was used for sealing of cystic artery and cystic duct. SPSS version 23 was used for data analysis. Complications between electrocautery and ultrasonic dissector were compared using chi-square test/Fischer exact test and operative time was compared using student’s t-test with p-value ≤ 0.05 considered as statistically significant.Results: Out of 150 patients planned for laparoscopic cholecystectomy, 33 (22%) were males and 117 (78%) females. The mean age was 40±6.45 years with an age range of 12-80 years. In group A, intraoperative gall bladder perforation was found in 5 patients whereas in group B, there was only one patient with perforation. A total of 4 cases were converted to open cholecystectomy in group A due to difficult dissection in Calot’s triangle as compared to 1 case in group B. In group A, 3 cases had postoperative bile leakage in the drain. In two patients it settled over a period of 3 days. About 03 cases had wound infection in group A and 1 in group B. Mean operative time in group A was 42.2±8.93 minutes versus 35.7±4.85 minutes in group B (p-value 0.001).Conclusion: In this study, the rate of post-operative complications was similar between the two groups, but operative time was significantly shorter in the group B. Harmonic dissector enabled easy dissection of tissues with good hemostasis and less trafficking of instrument, avoiding use of clips and sutures during minimal invasive surgery.

To Compare the Dissection of Gallbladder by Ultrasonic Harmonic Scalpel Versus Electrocautery in Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (5) ◽  
pp. 1498-1500
Author(s):  
H. B. Burki ◽  
Ghansham . ◽  
W. Afridi ◽  
V. Kumar ◽  
A. Hassan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Randomized Control Trial ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Easy Method ◽  
Post Operative Pain ◽  
The Mean ◽  
Randomized Control ◽  
Study Setting

Objectives: To assess the dissection of gallbladder by ultrasonic harmonic scalpel in comparison to electrocautery in laparoscopic cholecystectomy. Study Design: A randomized control trial Study Setting and Duration: Department of Surgery Ward-02 Jinnah Postgraduate Medical Centre, Karachi between June 2018 and February 2019. Methodology: A total of 110 patients diagnosed with cholelithiasis were included in the study. The participants were randomly allocated into two groups i.e., harmonic scalpel group and electrocautery group. Patients were followed postoperatively in the ward and the outcome was measured at the end of two days after surgery. Results: The average age of the patients was 44.56 ± 12.19 years. Out of 110 patients, 30 (27.3%) were male and 80 (72.7%) were female. It was found that the mean operative time (44.4 ± 3.64 min vs. 53.31 ± 8.09 min; p=0.0005), blood loss (10.27 ± 8.35ml vs. 4.00 ± 3.65ml; p=0.0005), post-operative pain (6.87 ± 1.04 vs. 4.29 ± 1.01 p=0.0005), and hospital stay (31.09 ± 10.58 vs. 24.11 ± 0.81; p=0.0005) were significantly lower in harmonic scalpel group than the electrocautery group. Conclusion: Dissection of gall bladder with harmonic scalpel is safe and easy method and superior then electrocautery and can routinely be used if available. Keywords: Laparoscopic cholecystectomy, Harmonic scalpel, Electrocautery

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