Total clipless cholecystectomy by means of harmonic sealing
| Autor: | Manoela Galvão Ramos, Natan Zundel, Josemberg Marins, Almino Ramos, Eduardo Lemos de Souza Bastos, Manoel dos Passos Galvão-Neto |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty RD1-811 medicine.medical_treatment RC799-869 Harmonic shears Cystic artery Young Adult Laparoscopic cholecystectomy Ultrasonic Surgical Procedures medicine.artery medicine Humans Prospective Studies CLIPS General surgery Aged computer.programming_language business.industry Gallbladder General Medicine Gallstones Middle Aged Diseases of the digestive system. Gastroenterology medicine.disease Surgery medicine.anatomical_structure Cholecystectomy Laparoscopic Cystic duct Female Original Article Cholecystectomy business Duct (anatomy) computer Artery |
| Zdroj: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva, Vol 28, Iss 1, Pp 53-56 (2015) Arquivos Brasileiros de Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.28 n.1 2015 ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) Colégio Brasileiro de Cirurgia Digestiva (CBCD) instacron:CBCD |
| ISSN: | 0102-6720 |
| Popis: | BACKGROUND: 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. AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. |
| Databáze: | OpenAIRE |
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