Abstract
Background
The influence of surgical operations on the systemic immune response is proportional to the degree of trauma. Ultrasonic surgery can dissect structures and divide vessels by the effect produced by vibrations in the tissues. It is believed to be less traumatic than the more commonly used monopolar electrosurgery. This randomized study compares the systemic immune response after laparoscopic cholecystectomy performed using either ultrasonic energy or monopolar electrosurgery.
Methods
Eighteen patients scheduled for elective laparoscopic cholecystectomy were randomly assigned to treatment using either a harmonic scalpel and clips or monopolar electrosurgery and clips. Postoperative inflammatory response was assessed via changes in the white blood cell count and levels of C-reactive protein. Postoperative immune function was assessed by measuring monocyte HLA-DR expression.
Results
Both the harmonic scalpel and the use of monopolar electrosurgery resulted in activation of the systemic immune response. No significant differences between the two groups were observed.
Conclusion
The harmonic scalpel and monopolar electrosurgery are equally traumatic in terms of activation of the systemic immune response.
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References
Amaral JF (1994) Ultrasonic dissection. Endosc Surg Allied Technol 2: 181–185
Amaral JF (1995) Laparoscopic cholecystctomy in 200 consecutive patients using an ultrasonically activated scalpel. Surg Laparosc Endosc 5: 255–262
Hambley R, Hebda PA, Abell E, Cohen BA, Jegasothy BV (1988) Wound healing of skin incisions produced by ultrasonically vibrating knife, scalpel, electrosurgery, and carbon dioxide laser. J Dematol Surg Oncol 14: 1213–1217
Hensman C, Baty D, Willes RG, Cuschieri A (1998) Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment. Surg Endosc 12: 1017–1019 DOI: 10.1007/s004649900771
Johnson A (1997) Laparoscopic surgery. Lancet 349: 631–635
Kloosterman T, von Blomberg ME, Borgstein P, Cuesta MA, Schepers RJ, Meijer S (1994) Unimpaired immune function after laparoscopic cholecystectomy. Surgery 115: 424–428
Maas SM, Hage JJ, Cuesta MA, Bloemena E (1998) Total laparoscopic ultrasonic dissection: is the colonic anastomisis safe? [Letter]. Surg Laparosc Endosc 8: 404–405
McAnena OJ, Willson PD (1993) Diathermy in laparoscopic surgery. Br J Surg 80: 1094–1096
Reddick EJ, Olsen DO (1990) Outpatient laparoscopic laser cholecystectomy. Am J Surg 160: 485–489
Vittimberga FJ, Foley DP, Meyers WC, Callery MP (1998) Laparoscopic surgery and the systemic immune response. Ann Surg 227: 326–334
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Online publication: 14 September 2000
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Sietses, C., Eijsbouts, Q.A.J., von Blomberg, B.M.E. et al. Ultrasonic energy vs monopolar electrosurgery in laparoscopic cholecystectomy. Surg Endosc 15, 69–71 (2001). https://doi.org/10.1007/s004640010061
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DOI: https://doi.org/10.1007/s004640010061