Sealing of Cystic Duct Using Ultrasonic Generator and Its Comparison with the Application of Clips - a Review

Ever since the beginning of laparoscopic Cholecystectomy, in 1985 by Erich Mühe in Germany followed by Harry Reich and Eddie Joe Reddick an American in 1989, the technique has seen many areas of refinements. Initially popularized techniques were turned down by the pioneers on the account of incredible and awful complications substantiated by controlled trials. The dissection of the cystic pedicle (which entails cystic duct division and the sealing of cystic artery), a crucial step in Gall Bladder surgery, has undergone revolutionary change since the introduction of harmonic Scalpel. The issue with clipping (absorbable & nonabsorbable) is that there is the complication of clips being dislodged. With the advent and use of ultrasonically activated scalpel a new chapter is rewritten for tissue cutting and co-agulation with potential replacement of electrosurgery by virtue of its complications. The safety profile of Harmonic Scalpel (HS) in other surgeries has been already demonstrated and documented. It’s use in Gall Bladder surgery in particular cholecystectomy needs more to be emphasized over the application of clips on cystic duct and the artery which underlines the aim of this study.