Title |
Total clipless cholecystectomy by means of harmonic sealing
|
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Published in |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), January 2015
|
DOI | 10.1590/s0102-67202015000100014 |
Pubmed ID | |
Authors |
Almino Cardoso Ramos, Manoela Galvão Ramos, Manoel dos Passos Galvão-Neto, Josemberg Marins, Eduardo Lemos de Souza Bastos, Natan Zundel |
Abstract |
In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement. To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver. Was evaluate a series of 125 patients who underwent laparoscopic cholecystectomy where the sealing and division of cystic artery and duct was carried out only by harmonic shears. The intact extracted gallbladder was submitted to a reverse pressure test for assessment of the technique safety by means of CO2 insuflation. The most common indication for surgery was gallstones. The mean operative time was 26 min and all gallbladders were dissected intact from the liver bed. There was no mortality and the overall morbidity rate was 0.8% with no hemorrhage or leaks. The reverse pressure test showed that all specimens support at least 36-mmHg of pressure without leaking. The harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Canada | 1 | 20% |
United Kingdom | 1 | 20% |
Unknown | 3 | 60% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 4 | 80% |
Practitioners (doctors, other healthcare professionals) | 1 | 20% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 13 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Other | 2 | 15% |
Professor | 2 | 15% |
Student > Bachelor | 2 | 15% |
Student > Doctoral Student | 1 | 8% |
Student > Ph. D. Student | 1 | 8% |
Other | 1 | 8% |
Unknown | 4 | 31% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 6 | 46% |
Social Sciences | 2 | 15% |
Arts and Humanities | 1 | 8% |
Unknown | 4 | 31% |