Minilaparoscopic cholecystectomy – the new non-visible scars technique. Preliminary report of first series
| Autor: | Bogna Ziarkiewicz-Wróblewska, Tadeusz Wróblewski, Konrad Kobryń, Marta Dec, Łukasz Nazarewski, Marek Krawczyk |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Umbilicus (mollusc) laparoscopy Scars Pneumoperitoneum Medicine Laparoscopy Original Paper medicine.diagnostic_test Common bile duct business.industry Gallbladder Gastroenterology Obstetrics and Gynecology medicine.disease Surgery medicine.anatomical_structure Cystic duct Cholecystectomy medicine.symptom minilaparoscopic cholecystectomy business scar-less surgery |
| Zdroj: | Videosurgery and other Miniinvasive Techniques |
| ISSN: | 1895-4588 |
| DOI: | 10.5114/wiitm.2015.52706 |
| Popis: | Introduction: Surgery without scars is the dream of many patients and surgeons as well. It includes many new lapa- roscopic techniques (LESS, SILS, hybrid NOTES), but data concerning common bile duct (CBD) lesions are unavailable. Aim: To establish the new technique of minilaparoscopic cholecystectomy (MCh): non-visible scar intervention with- out increasing the risk of CBD lesions. Material and methods: Forty consecutive patients with symptomatic gallbladder lithiasis were qualified for elective laparoscopic cholecystectomy (LCh) using one 10/11 mm umbilical port, one 5 mm right suprapubic port and two minilaparoscopic, disposable, no-port graspers. There were 26 women and 14 men, with the mean age 56 (17-72) years and with the average body mass index 28 (18-33) kg/m 2 . CO 2 Veress 15 mm Hg pneumoperitoneum was performed after transumbilical incision, and the first 10/11 mm port was inserted at the beginning for the 5 mm laparoscope and finally for typical instruments. Next under camera control, a 5 mm trocar was inserted in the right 'bikini line'. To this port the laparoscope was relocated from the umbilicus, and under its control two minilaparoscopic, disposable, non-port graspers were introduced after small, 2 mm skin incisions in the right anterior axillary line and in the right mesogastrium to catch the gallbladder. Next through the umbilical port, using typical instruments, the cystic duct and artery were dissected, clipped and cut. The gallbladder was removed through the umbilical port whole. Results: There was no conversion to open cholecystectomy. In 5 cases drainage of the gallbladder lodge was neces- sary through a 5 mm port in the right bikini line. The time of the intervention ranged from 90 min during the intro- duction of the new method to 50 min for the last procedures. No postoperative complications were observed, and all patients were discharged at the same time as after conventional LCh. Conclusions: Two-port laparoscopic cholecystectomy performed with two minilaparoscopic no-port graspers does not increase the risk of CBD lesions. It provides an excellent cosmetic effect and is very convenient for the surgeon like typical LCh. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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