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Bipolar versus monopolar cautery scissors for laparoscopic cholecystectomy: a randomized, prospective study
1Laparoscopic Surgery Center, Baptist Hospital, Miami Beach, Florida, USA.
Surgical Laparoscopy & Endoscopy
|December 1, 1995
Summary
Bipolar scissors offer a safe and effective alternative to monopolar scissors for laparoscopic cholecystectomy. While monopolar electrocautery provides superior coagulation, bipolar energy generates less smoke, ensuring comparable cutting ability and overall patient satisfaction.
Area of Science:
- Laparoscopic Surgery
- Surgical Energy Devices
Background:
- Monopolar electrocautery is popular in laparoscopic surgery due to cost and ease of use.
- Bipolar current is favored in gynecological procedures following reports of monopolar current injuries.
Purpose of the Study:
- To compare the efficacy and safety of bipolar scissors versus monopolar scissors for gallbladder dissection during laparoscopic cholecystectomy.
Main Methods:
- Eighty patients undergoing laparoscopic cholecystectomy were prospectively randomized to receive either bipolar or monopolar scissors.
- Scissors were evaluated based on cutting, coagulation, charring, and smoke production.
Main Results:
- Cutting ability and charring were comparable between bipolar and monopolar scissors.
- Monopolar scissors demonstrated superior coagulation, while bipolar scissors produced significantly less smoke.
- Patient demographics, blood loss, and hospital stay were similar between groups.
Conclusions:
- Bipolar scissors are a safe and effective device for dissecting the gallbladder from the liver bed in laparoscopic cholecystectomy.
- Bipolar scissors compare favorably to monopolar scissors, offering reduced smoke production.