الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Laparoscopic cholecystectomy (LC) is the gold standard for the surgical
treatment of symptomatic gallstones. The advantages of this surgical approach
have included a positive impact on the postoperative quality of the patient’s life
as well as optimal short- and long-term results
Alternative techniques for cystic duct closure have included sutures, a
three-throw reef knot, or Roeder slip knots. However, these alternatives are
technically more difficult and, therefore, were used infrequently
Ultrasonically activated scissors may divide both vessel and cystic duct,
with no need of further ligature, and possibly reduce the risk of thermal injuries
Designed as a safe alternative to electrocautery for the hemostatic
dissection of tissue, the ultrasonically, activated (Harmonic) scalpel was
introduced into clinical use nearly a decade ago
It was hypothesized that use of the harmonic scalpel for dissection of the
gallbladder would lessen the frequency of perforation in comparison with
electrocautery, and turn would improve the operative course of laparoscopic
cholecystectomy
Ultrasonic dissection produces a smaller zone of tissue damage and less
loss of nerve function, and has been suggested as an alternative to
electrocautery, it has been associated with a shorter operating time, reduced
hospital stay less blood loss compared with electrocautery dissection in a
randomized study of laparoscopic cholecystectomy.