[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
February 1993

Laser vs Electrosurgery in Laparoscopic CholecystectomyA Prospective Randomized Trial

Author Affiliations

From the Department of Surgery, University of Utah School of Medicine, Salt Lake City.

Arch Surg. 1993;128(2):233-236. doi:10.1001/archsurg.1993.01420140110018
Abstract

• While much of the clamor over the optimal instrument for dissection of the gallbladder from the liver bed has died, there remain no prospective comparative data concerning this issue. We undertook a prospective randomized trial comparing the contact neodymium:YAG laser with monopolar electrosurgical dissection in 100 patients undergoing laparoscopic cholecystectomy. Electrosurgical dissection was performed with an "L" hook and spatula electrodes at 25 W coagulation current. Neodymium:YAG laser dissection was performed with a 1200-μm contact tip at 15 W continuous beam. Mean (±SD) gallbladder dissection time was 19.2±8.5 minutes with electrosurgery compared with 23.6±9.6 minutes with the laser. Estimated blood loss was significantly less in the electrosurgery-treated group. In six instances, laser malfunction or fiber fragmentation necessitated completing the dissection with electrosurgery. We conclude that electrosurgery appears to have significant advantages for dissection of the gallbladder during laparoscopic cholecystectomy.

(Arch Surg. 1993;128:233-236)

References
1.
Zucker KA, Bailey RW, Gadacz TR, Imbembo AL.  Laparoscopic guided cholecystectomy . Am J Surg . 1991;161:36-44.Article
2.
Peters JH, Ellison EC, Innes JT, et al.  Safety and efficacy of laparoscopic cholecystectomy . Ann Surg . 1991;213:3-12.Article
3.
The Southern Surgeons Club.  A prospective analysis of 1518 laparoscopic cholecystectomies . N Engl J Med . 1991;324:1073-1078.Article
4.
Goodman GR, Hunter JG.  Results of laparoscopic cholecystectomy in a university hospital . Am J Surg . 1991;162:576-579.Article
5.
Berci G, Sackier JM, Paz-Partlow M.  Routine or selective cholangiography during laparoscopic cholecystectomy? Am J Surg . 1991;161:355360.
6.
Hunter JG.  Laser or electrocautery for laparoscopic cholecystectomy? Am J Surg . 1991;161:345-349.Article
7.
Voyles CR, Petro AB, Meena AL, Haick AJ, Koury AM.  A practical approach to laparoscopic cholecystectomy . Am J Surg . 1991;161:365-370.Article
8.
Corbitt JD.  Laparoscopic cholecystectomy: laser versus electrosurgery . Surg Laparascopic Endosc . 1991;1:85-88.
9.
Thompson BH, Wheeless CR.  Gastrointestinal complications of laparoscopy sterilization . Obstet Gynecol . 1973;41:669-676.
10.
Valez M, Reddick E, Kaivc M.  Should electrosurgery be used laparoscopically? The Halsted Health Harbinger . (March) 1991:1-4.
11.
American Health Consultants.  Are general surgeons ignoring lessons of gynecology? Clin Laser Monthly . 1991;9:1-4.
12.
Easter DW, Moosa AR.  Laser and laparoscopic cholecystectomy: a hazardous union? Arch Surg . 1991;126:423.Article
13.
Soper NJ, Dunnegan DL.  Does intraoperative gallbladder perforation influence the early outcome of laparoscopic cholecystectomy? Surg Laparosc Endosc . 1991;1:156-161.
×