A New Method of Laparoscopic Cholecystectomy Using Three Trocars Combined with Suture Retraction of Gallbladder

Endo, Shunji; Souda, Shigeo; Nezu, Riichiro; Yoshikawa, Yukinobu; Hashimoto, Junpei; Mori, Tadasu; Uchikoshi, Fumihiro

doi:10.1089/109264201750162310

Cited by 27 publications

(33 citation statements)

References 7 publications

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“…Our experience shows the feasibility of 5 mm-three trocars MLC in the treatment of acute and chronic cholecystopathy, with results comparable and equal to those reported for the conventional one [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Hospital stay…”

Section: Conversion Morbidity and Mortalitysupporting

confidence: 66%

“…Number one is the use of robotic for ease of use and precision of surgery [15,16]. Number two is the use of fewer trocars and the use of miniaturize instruments to reduce invasion to a minimum [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] and, number three, the recently reported single port approach [37][38][39]. Number one is not reproducible in every hospital situations, because of the problem of costs/benefit, while the second one seems to be applicable and feasible almost everywhere.…”

Section: Discussionmentioning

confidence: 99%

“…The 5 mm-three trocars MLC allows the same surgical procedures to be undertaken as for the conventional approach [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. In our experience, the length of surgery is equal if not less than that of our historical LC (47.56 min ± 31.2 min and 60 min ± 31.4), and all the surgeons of our team are able to ''reproduce'' the technique with no need to ''rewrite'' the single surgeon's learning curve.…”

Section: Treatment Optionsmentioning

confidence: 99%

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Is there still any role for minilaparoscopic-cholecystectomy? A general surgeons’ last five years experience over 932 cases

Agresta

Bedin

2011

Updates Surg

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Laparoscopy has rapidly emerged as the preferred surgical approach in a number of different diseases because it ensures correct diagnoses and appropriate treatment. The use of mini-instruments (5 mm or less in diameter) and, when possible, the reduction of the number of trocars used might be its natural evolution. Laparoscopic cholecystectomy is a gold standard technique. The aim of the present work is to illustrate the results of the prospective experience of minilaparoscopic cholecystectomy (5 mm MLC) performed at our institution. Between August 2005 and July 2010 a total of 932 patients (mean age 45 years) underwent a laparoscopic cholecystectomy. Amongst them, 887 (95.1%) were operated on with a 5 mm-three trocar approach and in the remaining 45 cases (4.8%) a 3 mm trocar was used. The primary endpoint was the feasibility rate of the techniques. Secondary endpoints were safety and the impact of the techniques on duration of laparoscopy. In two cases conversion to laparotomy was necessary. We needed to add a fourth-5 mm trocar in the 10.7% of the cases (95 patients) in the 5 mm MLC. There were two cases of redo-laparoscopy in this group due to bile leakage from the cystic duct in one case, and to bleeding from the gallbladder bed in the other. Minor occurrence ranged as high as 2.1% in the 5 mm-MLC group, while it was nil in the 3 mm-MLC patients. The present experience shows that the 5 mm-three trocars MLC is a safe, easy, effective and reproducible approach to gallbladder diseases. Such features make the technique a challenging alternative to conventional laparoscopy both in the acute and the scheduled setting. We consider the 3 mm-MLC approach suitable only in selected cases, young and thin patients, due to the fragility of the smaller instruments.

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Section: Conversion Morbidity and Mortalitysupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

See 1 more Smart Citation

Is there still any role for minilaparoscopic-cholecystectomy? A general surgeons’ last five years experience over 932 cases

Agresta

Bedin

2011

Updates Surg

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“…The use of a percutaneous sling has been also described to retract the gallbladder in two-port laparoscopic cholecystectomy. 8 Avoiding an additional abdominal incision, although small, might have potential advantages in terms of post-operative pain, safety and patients satisfaction.…”

Section: Discussionmentioning

confidence: 99%

One‐trocar salpingectomy for the treatment of tubal pregnancy: a ‘marionette‐like’ technique

Ghezzi

Cromi

Fasola

et al. 2005

BJOG

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Laparoscopic salpingectomy for the treatment of tubal pregnancy has traditionally been performed with two ancillary trocars. We report a novel single-port technique requiring only an umbilical operative laparoscope and a percutaneous midline suture, inserted with a straight needle, to retract the affected fallopian tube. A total of 10 ectopic pregnancies have been successfully treated with this approach. The procedure was not technically demanding and the operative time was comparable to that of standard laparoscopic methods. No intraoperative and postoperative complication occurred. Ancillary trocars were not necessary in any of these cases. Our results showed that one-trocar salpingectomy is a feasible and safe technique.

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“…Literatürde benzer birçok makale mevcuttur. [6][7][8] Birçok araştırmacı 3 port LK'nin kullanımını bizim gibi elektif olgularda bildirmiştir. Akut kolesistitli olgularda uygulayanlar da mevcut olup görece olarak daha sınırlıdır.…”

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Effects of patients with three port laparoscopic cholecystectomy

Kanat¹,

Gırgın²

2012

J Kartal TR

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ÖzetAmaç: Bu çalışmada, semptomatik safra kesesi taşı nedeniyle üç porttan laparoskopik kolesistektomi (LK) yapılan olgular geriye dönük olarak incelendi ve üç port LK'nın güvenli-ği araştırıldı. Gereç ve Yöntem:Semptomatik safra kesesi taşı nedeniyle LK yapılan toplam 32 hasta geriye dönük olarak incelendi. Hastalarda dördüncü port gereksinimi, ameliyat süresi, ve komplikasyon oranları incelendi. Bulgular:Olguların 24'ü (%75) kadın, 8'i (%25) erkekti. 32 hastanın 29'una (%90.6) üç porttan güvenli bir şekilde LK uygulandı. Üç (%9.4) olguda dördüncü trokar gereksinimi oldu. Hiçbir olguda safra fistülü, safra sızıntısı veya safra yolu yaralanması gibi majör komplikasyonlar ya da mortalite izlenmedi.Sonuç: Semptomatik kolelithiyazisli hastalarda uygulanan 3 port LK'nin güvenli olduğu ve morbiditeyi artırmadığı gö-rüldü.Anahtar sözcükler: Güvenli kolesistektomi; laparoskopik kolesistektomi; port sayısı. AbstractBackground: In this study, we aimed to examine patients with three port-laparoscopic cholecystectomy (LC) due to symptomatic cholelithiasis and to investigate the safety of the three-port LC, retrospectively.

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A New Method of Laparoscopic Cholecystectomy Using Three Trocars Combined with Suture Retraction of Gallbladder

Abstract: This method also has cosmetic advantages. Therefore, we believe this method might be recommended for LC.

Cited by 27 publications

References 7 publications

Is there still any role for minilaparoscopic-cholecystectomy? A general surgeons’ last five years experience over 932 cases

Is there still any role for minilaparoscopic-cholecystectomy? A general surgeons’ last five years experience over 932 cases

One‐trocar salpingectomy for the treatment of tubal pregnancy: a ‘marionette‐like’ technique

Effects of patients with three port laparoscopic cholecystectomy

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