The MC procedure seems to be a faster technique than the LC approach for noncomplicated gallstone disease, with no difference in recovery times. The MC procedure also seems to be suitable for the obese patient.

BackgroundWhile 3D laparoscopy increases surgical performance under laboratory conditions, it is unclear whether it improves outcomes in real clinical scenarios. The aim of this trial was to determine whether the 3D laparoscopy can enhance surgical efficacy in laparoscopic cholecystectomy (LCC).MethodThis prospective randomized controlled study was conducted between February 2015 and April 2017 in a day case unit of an academic teaching hospital. Patients scheduled for elective LCC were assessed for eligibility. The exclusion criteria were: (1) planned secondary operation in addition to LCC, (2) predicted to be high-risk for conversion, and (3) surgeons with less than five previous 3D laparoscopic procedures. Patients were operated on by 12 residents and 3 attendings. The primary endpoint was operation time. All surgeons were tested for stereoaquity (Randot® stereotest). The study was registered in ClinicalTrials.gov (NCT02357589).ResultsA total of 210 patients were randomized; 105 to 3D laparoscopy and 104 to 2D laparoscopy. Median operation time as similar in the 3D and 2D laparoscopy groups (49 min vs. 48 min, p = 0.703). Operation times were similar in subgroup analyses for surgeon’s sex (male vs. female), surgeon’s status (resident vs. attending), surgeon’s stereovision (stereopsis 10 vs. less than 10), surgeon’s experience (performed 200 LCCs or below versus over 200 LCCs), or patient’s BMI (≤ 25 vs. 25–30 vs. > 30). No differences in intra- or postoperative complications were noted between the 3D and 2D groups.Conclusion3D laparoscopy did not show any advantages over 2D laparoscopy in LCC.

both MC and LC are feasible surgical techniques for day surgery. However, appropriate prevention and prompt management of established postoperative nausea and vomit-ing and careful patient selection are important aspects for success of short-stay approach. If there is a sign of chronic cholecystitis preoperatively, it might be considered as a contraindication for day surgery.

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as ad ay surgery procedure.Patients and Methods: Thirty electives ymptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27-68), the mean body mass index 29 kg/m 2 (range 19-41). Gallstones were confirmed with ultrasound and the preoperative liver laboratory tests were normal in all patients. Afive (+/-2)centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter.Results: The average operating time was 51 minutes (range 30-105 minutes). Day surgery was possible in 25 cases(83%).Fivepatients (17%) stayedover nightatthe hospital. There were four (13%) conversions to conventional cholecystectomy.T he average postoperative sick leave was 16 days (range 14-30).T wo patients returned to hospital. One patienthad wound pain,but no complicationwas found, andthe patientwas notadmitted. One patient had aw ound infection and spent6d ays in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients.Conclusions: The results of this study support the suitability of MC as aday surgery procedure, but aprospective randomised trial is needed to evaluate the relative advantages of MC and LC.