Is mini-laparoscopic cholecystectomy any better than the gold standard?: A comparative study

Abstract

BACKGROUND:Mini-laparoscopic cholecystectomy (MLC) has widened the horizons of modern laparoscopic surgery. Standard four port laparoscopic cholecystectomy (SLC), which has long been established as the “Gold Standard” for gall bladder diseases, is under reconsideration following the advent of further minimally-invasive procedures including MLC. Our study aims to provide a comparison between MLC and SLC and assesses whether MLC has any added benefits.MATERIALS AND METHODS:Patients with symptomatic gall bladder disease undergoing MLC or SLC during the 2.5-month period were included in the study. Thirty-two patients underwent MLC while SLC was performed on 40 patients by the same surgeon. Data was collected prospectively and analysed retrospectively using a predesigned questionnaire.RESULTS:In our study, both the groups had similar age, body mass index (BMI) and gender distribution. No cases of MLC required insertion of additional ports. The mean operative time for MLC was 38.2 min (33-61 min), which is longer than SLC; but it was not statistically significant. There was no significant difference in mean operative blood loss, postoperative pain, analgesia requirement and mobilization. Patients who underwent MLC were able to return to normal activity earlier than patients undergoing SLC (P < 0.01).CONCLUSION:Our experience suggests that MLC can safely be used as an alternative to SLC. Compared to SLC, it has the added benefit of an early return to work along with excellent cosmetic results. Further large scale trials are required to prove any additional benefit of MLC.

Feasibility and Safety of Three-Port Laparoscopic Cholecystectomy Compared to Four-Port Laparoscopic Cholecystectomy

“…Standard four-port laparoscopic cholecystectomy (LC) is considered to be a gold standard technique for cholecystectomy [ 1 , 2 ].…”

Mini-laparoscopic cholecystectomy: evolution of a new technique

“…It is notable that in their study, an endocatch bag was used to deliver the GB out through the 5 mm port, which is different from the technique described in our paper. Shaikh et al compared the use of the standard four trocars (10 mm × 2, 5 mm × 2) with mini-laparoscopic cholecystectomy using three 3 mm ports and one 10 mm port, and found that the latter was not only comparable to the standard ports in terms of blood loss, post-operative pain, analgesia requirement and mobilisation, but was also associated with earlier return to work and superior cosmetic outcomes [ 15 ].…”

The Comparison of Postoperative Pain, Nausea, and Vomiting between Veress Needle Entry and Direct Trocar Entry Methods in Patients Undergoing Laparoscopic Cholecystectomy

“…They have suggested that the mini-port technique has more cosmetic outcomes than the standard-port technique; however, they have a similar effect on pain, nausea, and vomiting after LC. 20 - 22 Results of single-incision LC are inconsistent. 23 - 25 Type of anesthesia also contributes to the occurrence of complications after LC.…”