Publication:

Observational study of use of harmonic scalpel vs electrocautery in dissection and removal of gallbladder from gallbladder bed in laparoscopic cholecystectomy

Background The harmonic scalpel uses ultrasonic vibrations at a high frequency to cut tissue and coagulate blood vessels. Electrocautery uses electrical current to generate heat, which cuts tissue and coagulates blood vessels. Both energy sources are used for dissection of gallbladder with each having their own merits and demerits.

Objectives To assess the outcomes and complications of using harmonic Scalpel vs electrocautery for laparoscopic cholecystectomy.

Methods Observational retrospective study, conducted at a tertiary healthcare center (Sassson General Hospital, Pune). Data collection over 24 months (December 2022-December 2024), enrolled 100 patients diagnosed with cholelithiasis. The key outcomes measured - the average operating time, the average frequency of lens cleaning, the average VAS score on POD 1, the average length of stay postoperatively, duration of drain and number of complications.

Results The average operating time using electrocautery vs harmonic scalpel was 55.67 vs 41.52 minutes, average frequency of lens cleaning  5 vs 3.24 times, average VAS score on post operative day 1 to be 4.321 vs 3.264,average length of stay post-surgery  to be 3.58 vs 2.38 days ,average duration of drain to be 2.681 vs 2.324 days ,number of gallbladder perforations to be 5 vs 2.

Conclusions The harmonic scalpel demonstrated improved patient outcomes for operating time, length of stay, duration of drain, drainage volume, postoperative pain and overall complications compared to electrocautery.