Gallbladder Dissection in Lap Cholecystectomy Using L-hook Versus Harmonic Scalpel

Syed Jawad Shah, doctor

Holy Family Hospital, rawalpindi, pakistan

INTRODUCTION: Laparoscopic cholecystectomy has made removal of gallbladder with open technique almost obsolete. Although standardized techniques have been laid there still llie surgeons own preferences. Gallbladder dissection from liver bed is being practiced widely using both l-hook and harmonic. this study is focuses on comparison of gallbladder wall perforations using l-hook and harmonic.

METHODS AND MATERIALS: This study was conducted at surgical department, holy family hospital, Rawalpindi over a period of 6 months. A comparative descriptive study conducted, using two study groups, group A patients underwent gallbladder dissections using harmonic scalpel, while in group B patient study groups L-hook was used for same purpose. In both study groups consultant surgeons performed the procedures to match expertise level.

RESULTS: In GROUP A, out of 100 patients (88 females, 12 males) in total, in 9 patients gallbladder walls were breached, out of which 3 were female(34), and 6 were male patients (64%). In GROUP B (92 females, 8 males) there were 21 gallbladder wall perforations (21%), with 6 males and 15 female patients.

CONCLUSION: In the light of our study it is evident that there were lesser no of injuries to gallbladder wall while dissecting it out from its liver bed, using Harmonic in comparison to L-hook. Therefore it goes without saying that even in the hands of expert surgeons with established expertise Harmonic is relatively safer than L-hook whle dissecting gallbladder from liver bed in lap. Cholecystectomy.

Session: Poster Presentation

Program Number: P543