Gasless single-port laparoscopic cholecystectomy

Abstract

Purpose: Single-port laparoscopic surgery is anticipated to become the future of minimally invasive surgery. We have devised an alternative approach for laparoscopic cholecystectomy by inserting a single port at the umbilicus and using the abdominal wall-lif ting method, without establishing pneumoperitoneum.Methods: Retrospective analysis of 130 patients undergoing laparoscopic cholecystectomy was done to compare the conventional laparoscopic cholecystectomy (CLC) (n = 69) and the novel single-port laparoscopic cholecystectomy (SLC) using the abdominal wall-lifting method (n = 61). The surgical procedures were as follows. A 2-to 3-cm transumbilical incision was made, and a wound retractor was inserted into the abdomen without difficulty. Abdominal distension was obtained using a fan-shaped retractor without the use of carbon dioxide insufflations. A 5-mm flexible scope and modified curved graspers and dissectors were used to give the feeling of triangulation during dissection. Results:The SLC group consisted of 25 males and 36 females with a mean age of 58.1 ± 7.2 years and a mean body mass index of 23.1 ± 3.2 kg/m 2 . The two groups were comparable for mean age, sex, disease, American Society of Anesthesiologists physical status classification, and comorbidity. Likewise, the duration of operation, postoperative hospital stays, complications, the number of use of analgesics, and conversion rate to open technique were not significantly different in the two groups. Conclusion:The impaired view in single-port laparoscopic surgery can be improved by using articulating instruments that can be rotated out of the field of view. This novel gasless method is cost-effective and produces minimal postoperative discomfort with no additional scars.

Kết Quả Theo Dõi Dài Hạn Phẫu Thuật Nội Soi Một Lỗ Cắt Túi Mật

“…Kết quả này ủng hộ cho các tuyên bố của các tác giả khác về phẫu thẫu thuật nội soi một lỗ là ít đau. Cũng đã có nhiều nghiên cứu so sánh mức độ đau sau mổ của cắt túi mật nội soi một lỗ và cắt túi mật nội soi truyền thồng và đa số các tác giả đều đưa đến kết luận là phẫu thuật nội soi một lỗ ít đau hơn so với phẫu thuật nội soi truyền thống trong cắt túi mật [5,6,8].…”

Indicators for conversion from laparoscopic to open cholecystectomy. A clinical study.

“…[6][7][8][9][10][11] In the unwanted circumstance during the process numerous cases of laparoscopic cholecystectomies are redirected to open surgeries despite the fact that hospital stays along with mortality and morbidity rates are maximum in open surgeries as compared to laparoscopic surgeries. [7][8][9] However, certain anatomical abnormalities and difficulties during surgery may require open surgical incisions instead of laparoscopic surgery, which can increase the risks of hospital stays, morbidity, and mortality. [12][13][14][15]…”