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Nazih Salameh Amarin
resumption of normal activities were not studied. In a previous 2. Carbonell AM, Joels CS, Kercher KW, Matthews BD, Sing RF,
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investigation, Tsimoyiannis et al demonstrated comparable Heniford BT. A comparison of laparoscopic bipolar vessel
recovery times in patients undergoing laparoscopic sealing devices in the hemostasis of small-, medium-, and large
cholecystectomies using ultrasonically activated shears for sized arteries. J Laparoendosc Adv Surg Tech A 2003;13:377–
dissection when compared with patients undergoing the more 80.
traditional clip and cautery technique. Subjective observations 3. Denes B, de la Torre RA, Krummel TM, Oleson LSM. Evaluation
throughout this study would substantiate this finding. There of a vessel sealing system in a porcine model. In 21st World
Congress of Endourology, Moderated Poster Session,
appears to be a cost benefit when using a single disposable Endourology/Laparoscopy: Laboratory and Teaching Montreal,
instrument (LCS-C5 Harmonic scalpel blade tip), especially when Canada 2003.
compared with the usage of the disposable Endoshears and 4. Landman J, Kerbl K, Rehman J, Andreoni C, Humphrey PA,
clip-applier in combination. At Clark Memorial Hospital, the Collyer W, Olweny E, Sundaram C, Clayman RV. Evaluation of
difference is approximately $20.00 per case. The cost benefit is a vessel sealing system, bipolar electrosurgery, harmonic scalpel,
more apparent in cases where other disposable instruments are titanium clips, endoscopic gastrointestinal anastomosis vascular
used in conjunction with the Harmonic scalpel. However, it staples and sutures for arterial and venous ligation in a porcine
would be unrealistic to extrapolate these savings on a national model. J Urol 2003; 169:697–700.
level. Instrument costs vary considerably across the United 5. Gozen AS, Teber D, Rassweiler JJ. Principles and initial
States, depending on manufacturer fees, regional distribution experience of a new device for dissection and hemostasis. Minim
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would be realized in the majority of the country. 6. Lee CL, Huang KG, Wang CJ, Lee PS, Hwang LL. Laparoscopic
radical hysterectomy using pulsed bipolar system: comparison
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The Harmonic scalpel is a safe, efficient, and practical instrument 7. Spivak H, Richardson WS, Hunter JG. The use of bipolar cautery,
to use during laparoscopic cholecystectomies, and its role can laparosonic coagulating shears, and vascular clips for hemostasis
be expanded to include complete hemobiliary stasis. of small and medium-sized vessels. Surg Endosc 1998;12:183–
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