AbstractTo evaluate safety and efficacy of ultrasonic scalpel in closure/division of the cystic duct and artery, and gallbladder dissection in laparoscopic cholecystectomy as a single working instrument compared conventional technique using clips and electro-cautery. Method: This study included 60 patients with symptomatic gallstone disease were randomly assigned for laparoscopic cholecystectomy by either ultrasonic shear ( Study Group = 30 patients), and clip / cautery (Control Group=30 patients). Results: The mean operative time was significantly shorter in study group as compare to control group ( p value =0.002), and postoperative pain scores (VAS) were significantly shorter (p value = 0.001) in first 24 hours but no significant difference was found in the incidence of intra-operative & post-operative complications. Conclusion: Ultrasonic shear is as safe and effective as clip/cautery technique in achieving hemo-biliary stasis, with shorter operative time with decreased pain, especially if used as a sole working instrument.
Keywords: Clipless laparoscopic cholecystectomy (CLLC); Conventional laparoscopic cholecystectomy (CLC); Ultrasonic scalpel.