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

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.

scholarly journals Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 1143
Author(s):  
Megha Chaudhary ◽  
Maitri Shah ◽  
Nitin Makwana
Keyword(s):  
Blood Loss ◽  
Randomized Control Trial ◽  
Tertiary Care ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Third Stage ◽  
The Mean ◽  
Randomized Control

Background: Labour is a physiological process, but it is often associated with morbidity and mortality, with the most common cause being blood loss. Primary postpartum hemorrhage is commonly defined as a blood loss of 500 ml or more within 24 hours after normal vaginal birth. A prolonged third stage of labour (more than 20 min) is associated with postpartum hemorrhage. The present study was undertaken with the objective of assessing efficacy of placental cord drainage (PCD) during active management of third stage of labour.Methods: This is a randomized control trial in which full term primi gravida who were expected to have normal vaginal delivery, admitted in labour room of a tertiary care centre were evaluated for inclusion in the study. Total 126 participants were enrolled after having normal vaginal delivery. In study group (n = 63), placental cord drainage was used for management of third stage of labour while in control group (n = 63), third stage was managed without PCD.Results: The mean difference in duration of third stage of labour in study and control group was 1.79 minute and the mean difference in blood loss during third stage of labour in both groups was 57.86 ml which was statistically significant.Conclusions: The results of this study show small positive effects from cord drainage in reducing the length of the third stage of labour and in reducing the amount of blood loss when compared with those without cord drainage. The observed changes may be of clinical significance in reducing third stage related complications.

scholarly journals Laparoscopic transabdominal preperitoneal inguinal repair versus open Lichtenstein repair: a randomized control trial

2017 ◽  
Vol 5 (1) ◽  
pp. 77
Author(s):  
Darshan A. Manjunath ◽  
Umeshchandra D. Gurugunti ◽  
Veerabhadra Radhakrishna
Keyword(s):  
Hernia Repair ◽  
Hospital Stay ◽  
Randomized Control Trial ◽  
Operative Time ◽  
Preperitoneal Repair ◽  
Lichtenstein Repair ◽  
Transabdominal Preperitoneal ◽  
Operative Complications ◽  
The Mean ◽  
Randomized Control

Background: There have been a plenty of evolution in surgical techniques of hernia repair. The current standard technique is tension-free repair. The different studies show different results with the use of laparoscopy in performing tension-free hernia repair. Hence a study was conducted to compare the laparoscopic transabdominal preperitoneal repair with open Lichtenstein repair regarding operative complications, pain, analgesic usage, and time to return to normal activities.Methods: A randomized control trial was conducted in the Department of General Surgery in a tertiary center from December 2010 to May 2012. All patients underwent either open Lichtenstein repair or laparoscopic transabdominal preperitoneal repair (TAPP). Both the procedures included a recording of operative time, operative complications, pain, analgesic usage, hospital stay, surgical site infection (SSI), and time to return to normal activities. Mann Whitney U test, student ‘t’ test and Fisher’s exact test were used to study the significance of the difference. A p-value <0.05 was considered significant.Results: The open Lichtenstein procedure was found to have a significantly less operative time compared to TAPP procedure (54±15 minutes vs. 75.7±31.6 minutes; p=0.001; CI=95%; Mann Whitney ‘U’ test). TAPP group had a significantly low pain at 12hrs and 24hrs postoperatively. There was no difference between the TAPP group and Lichtenstein group regarding the mean hospital stay (37.2±12.1 hours vs. 38.2±13.6 hours; p=0.7; CI=95%; Mann Whitney ‘U’ test). The mean time to return to work was 12.1±11.8 days in TAPP group, which was significantly lesser than the Lichtenstein group (20.9±4 days; p= 0.04; CI=95%; student ‘t’ test). No recurrence was found.Conclusions: Laparoscopic TAPP was a safe and effective procedure for inguinal hernia repair, and it can replace open procedure.

scholarly journals Efficacy and Safety of Microdebrider Assisted Adenoidectomy over Conventional Adenoidectomy

2020 ◽  
Vol 28 (1) ◽  
pp. 59-66
Author(s):  
Anil S Harugop ◽  
Samanvaya Soni ◽  
Tejaswini J S
Keyword(s):  
Blood Loss ◽  
Randomized Control Trial ◽  
Operative Time ◽  
Conventional Group ◽  
Efficacy And Safety ◽  
Intraoperative Blood Loss ◽  
Average Amount ◽  
Adenoid Tissue ◽  
Randomized Control ◽  
One Year

Introduction Adenoidectomy has conventionally been performed by curetting the adenoid tissue blindly with St. Clair Thompson curette leading to inadequate removal of tissue. Here the use of endoscopic guided adenoidectomy with microdebrider has been employed to compare the two methods.   Materials and Methods It is a one-year randomized control trial conducted from January 2018 to December 2018. Patients were allocated into 2 groups i.e. conventional adenoidectomy and microdebrider adenoidectomy group. Pre and post-operative endoscopic grading of adenoid was compared and intraoperative blood loss and operative time were studied.   Results Total 45 patients included 25 in conventional and 20 in microdebrider group. Following adenoidectomy operation the percentage of reduction of adenoid grading in microdebrider group was 63.79 % whereas 30.29% in conventional group, the average time taken by microdebrider assisted surgery was 16.45 mins as compared to 13.28 mins in conventional curettage. The average amount of blood loss in conventional group was 44.76 ml whereas in microdebrider group was 77.30 ml.   Conclusion Microdebrider assisted adenoidectomy has proven to deliver completeness of clearance at the expense of slight increase in bleeding and the operative time.

scholarly journals SURGICAL INCISION;

2018 ◽  
Vol 25 (06) ◽  
pp. 796-798
Author(s):  
Mohammad Touseef Asghar ◽  
Rizwan Ahmad Khan ◽  
Sadaf Ishaque ◽  
Danish Imtiaz ◽  
Salman Abdul Basit
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Randomized Control Trial ◽  
Bleeding Control ◽  
Surgical Incision ◽  
Vertical Incision ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Better Than

Objectives: To compare the outcome variables among patients undergoinglaparoscopic cholecystectomy using horizontal and vertical incisions for epigastric port incision.Study Design: Randomized control trial. Place and Duration of Study: Department of Surgery,Shalamar Hospital, Lahore from July 2016 to December 2016. Methodology: A total of 100patients undergoing laparoscopic cholecystectomy were selected and equally divided intotwo groups. Epigastric port insertion was done using horizontal incision (group A) and verticalincision (group B). Electrocautery use, incision extension, use of secondary intervention forbleeding control, blood loss and patient satisfaction regarding scar were noted in both groupsand compared. Results: In this study, we found that 15 out of 50 required electrocautery ingroup A while only 4 patients required in group B. Incision extension was needed in 8% ofpatients in group A while only 2% patients needed it in group B. Blood loss was 4.62 ± 2.64ml in group A while in group B, it was 1.70 ±0.81 ml. Also 80 % patients were satisfied withhorizontal scar while 76 % patients in vertical group. Conclusion: Vertical incision for epigastricport insertion is better than horizontal incision in terms of blood loss, bleeding control whencompared in laparoscopic cholecystectomy.

scholarly journals Safety and feasibility of three port procedure in laparoscopic cholecystectomy

2019 ◽  
Vol 6 (6) ◽  
pp. 1975
Author(s):  
Vipin Gupta ◽  
Shailendra Pal Singh ◽  
Somendra Pal Singh ◽  
Anil Kumar Keshari ◽  
Anil Kumar Erry ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Standard Technique ◽  
Post Operative Pain ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic cholecystectomy is widely accepted gold standard technique for management of cholelithiasis and has undergone many refinements including decrease in size and number of ports. Many researchers have claimed that three-port laparoscopic cholecystectomy is safe and feasible method for management of cholelithiasis but still it is not performed widely by the surgeons. Objective of our study was to assess the safety and feasibility of three-port laparoscopic cholecystectomy by comparing the various defined parameters with the standard four-port laparoscopic cholecystectomy.Methods: The study included 100 patients and was divided equally in 2 groups. Patients in Group A underwent laparoscopic cholecystectomy by three-port technique and in Group B were operated by four-port technique. Patients in both the groups were compared in terms of operative time, intra-operative complications, post-operative pain, post-operative complications and cosmesis outcome.Results: The mean operative time was similar in both groups. Intra-op and post-op complications were also similar. 3 patients in Group A needed fourth port and 1 patient in both group required conversion to open cholecystectomy. Mean pain score and requirement of parentral analgesia was found to be lower in Group A. Duration of hospital was similar in both the groups. Patients in group A had slightly better cosmetic outcome.Conclusions: Three-port laparoscopic cholecystectomy is a minimally invasive, safe and feasible technique and is not difficult to master than other advanced techniques. In experienced hands, laparoscopy cholecystectomy can be initially started with three-ports and can be converted to four-port if rarely necessary.

scholarly journals Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098278
Author(s):  
Xing Du ◽  
Yunsheng Ou ◽  
Guanyin Jiang ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Bone Graft ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Operative Time ◽  
Bone Grafts ◽  
Surgical Indications ◽  
Operative Blood Loss ◽  
The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

2021 ◽  
pp. 155335062098822
Author(s):  
Eirini Giovannopoulou ◽  
Anastasia Prodromidou ◽  
Nikolaos Blontzos ◽  
Christos Iavazzo
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Single Site ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Robotic Myomectomy ◽  
The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

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