Closure of the Cystic Duct: Comparison to Harmonic Scalpel Versus Clip Application in Single Incision Laparoscopic Cholecystectomy
Huseyin Yilmaz*, Husnu Alptekin, Ilhan Ece, Akin Calisir and Mustafa Sahin
Department of General Surgery, Medical Faculty of Selcuk University, Konya, Turkey
- *Corresponding Author:
- Huseyin Yilmaz
Selcuk Universitesi A. Keykubat Kampusu
Selcuklu Tip Fakultesi Genel Cerrahi Klinigi 42075 Konya, Turkey
E-mail: [email protected]
Received date: November 18, 2013; Accepted date: December 30, 2013; Published date: January 08, 2014
Citation: Yilmaz H, Alptekin H, Ece I, Calisir A, Sahin M (2014) Closure of the Cystic Duct: Comparison to Harmonic Scalpel Versus Clip Application in Single Incision Laparoscopic Cholecystectomy. J Gastroint Dig Syst 4:165. doi:10.4172/2161-069X.1000165
Copyright: © 2014 Yilmaz H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Backround: Single incision laparoscopic cholecystectomy [SILC] is usually performed using titanium clips [TC]
for occlusion of the cystic duct and cystic artery. The use of Harmonic scalpel [HS] in SILC to be applied has been
reported. In this study we aimed to compare effect of HS and TC application for closure of the cystic duct and artery
in patients undergoing SILC.
Methods: Totally 70 patients were operated using SILC technique from May 2011 to Jan 2012. 37 patients
underwent single incision laparoscopic cholecystectomy with titanium clips [TC-SILC] and 33 patients underwent
single incision laparoscopic cholecystectomy with hormonic scalpel [HS-SILC]. In the TC-SILC group, closure of the
cystic duct and artery was achieved by applying simple TC. In the HS-SILC group, HS was used for the closure and
division of both cystic duct and artery. Demographics, diagnosis, operative data, complications and length of hospital
stay were compared between the two groups.
Results: Patients demographics were not different between the groups. Conversion to open surgery or need of
additional port was not necessary in any patient. The operative data were similar in both groups. Superficial wound
infection was seen in one patient in TC group which was trated by oral antibiotics. During the follow-up period, one
port-site hernia was detected in a patient who underwent TC-SILC.
Conclusions: The HS seems to be a feasible, effective and a safe technique for performing SILC on selected
patients. However, complications of TC was thought to be rare in experienced hands, and the cost of HS should be
also considered prior to adopting the technique.