Laparoscopic cholecystectomy [LC] is accepted as the ââgold standardââ surgical treatment of gallbladder benign diseases due to its
optimal postoperative results and enhanced quality of the life. Single-incision laparoscopic operations have recently emerged as
used in minimal invasive alternative to conventional laparoscopy. HS is used to the single incision laparoscopic cholecystectomy [SILC] for
laparoscopic removal of the gallbladder safely, short surgical time and a shorter length of hospital stay. The standard LC is usually performed using monopolar
electrosurgical hook for dis section and clips for ligation of the cystic duct and cystic artery. Standard closure of cystic duct during LC by
titanium surgical clips [TC] is the most frequently used technique to achieve both cystic duct and artery closure. In LC, alternative
techniques for duct ligation have included linear stapler, endoloops,knot and HS. Recently SILC is usually performed using titanium
clips [TC-SILC] for occlusion of the cystic duct and cystic artery.Several studies have described the use of ultrasound dissection
technology in LC where ultrasonic devices have been used in dissection of the gallbladder. The ultrasonically activated scalpel [HS,
Harmonic Scalpel-Ethicon Endo Surgery INC] was introduced into clinical use more than two decades ago. Its technology relies on the
application of ultrasound within the harmonic frequency range to tissues and allows two effects: ultrasonic coagulation and cutting.
Large series studies have demonstrated the effectiveness and safety of the use of the HS for dissection of the gallbladder, some
researchers have found that the titanium clip to be more effective for closure of cystic duct and artery.
Last date updated on September, 2020