Efficacy of harmonic scalpel in total clipless laproscopic cholecystectomy

Laparoscopic cholecystectomy (LC) is a well-known benchmark in the surgical management of gall bladder stones. It has numerous advantages such as its minimal invasiveness and faster recovery for patients. Harmonic scalpel (HS) has been widely used for cystic duct and artery closure. This study aimed to investigate efficacy of HS in the closure of the cystic artery and duct, its beneficial aspects and, if it is a safe instrument. This study included 75 patients had LC performed using HS in closure and division of both the cystic duct and artery with dissection of the gallbladder by it. The perioperative data were recorded. LC was successfully conducted on all included patients; the average duration of the procedures was 35.6±7.1 mins. There is a lower incidence of gallbladder perforation with subsequent avoidance of time loss. No mortality no intraoperative bile duct injury or perioperative bleeding were reported. Nevertheless the major postoperative morbidity rate was in 3 cases 4.0% (one case bile leak from accessory duct, and 2 cases port site infection), The HS is an efficient tool for complete hemo-biliary sealing; it enhances the operative course of elective LC.