Comparative study to evaluate ultrasonic verses monopolar electrocautery dissection of gall bladder in laparoscopic cholecystectomy


  • Himanshi Mathur Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India
  • Ashok Kumar Sharma Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India
  • Dheer Singh Kalwaniya Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India



Laparoscopic cholecystectomy, Monopolar electrocautery, Ultrasonic scalpel


Background: Gallstones are one of the most common routinely encountered surgical problem in the developed world. Laparoscopic cholecystectomy being the gold standard surgery for gall stones has been modified various times using different instruments in order to improve intraoperative and postoperative outcomes. The aim of the study was to see clinical outcomes of ultrasonic scalpel verses monopolar electrocautery in dissection of gall bladder in laparoscopic cholecystectomy.

Methods: A prospective randomized controlled study was done with total 100 patients in which 50 patients underwent laparoscopic cholecystectomy via ultrasonic scalpel while rest 50 patients were operated using monopolar electrocautery. The study was conducted for a period of eighteen months and clinical outcomes were studied in terms of operative time, frequency of lens cleaning, gall bladder perforation, biliary leak, common bile duct injury, bowel perforation and postoperative hospital stay.

Results: The two groups were comparable in terms of demographic profile considering age and sex distribution. However, there was a statistically significant reduction in operative time, frequency of lens cleaning and gall bladder perforation in group A (harmonic scalpel) as compared to group B (electrocautery).

Conclusions: Harmonic scalpel is not only a safe and effective instrument but also a reliable alternative to electrocautery. Even though the study revealed no significant difference in biliary leak, common bile duct injury, bowel perforation and postoperative hospital stay but it can significantly reduce operative time and incidence of gall bladder perforation. Thus, it can improve the operative course in laparoscopic cholecystectomy.

Author Biographies

Himanshi Mathur, Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India

junior resident




Ashok Kumar Sharma, Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India

Associate professor

department of general surgery

safdarjung hospital 

new dehi 

Dheer Singh Kalwaniya, Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India

Assistant professor

department of general surgery

safdarjung hospital

new delhi


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Original Research Articles