Transumbilical multiple-port laparoscopic cholecystectomy using standard laparoscopic instruments


Oruc M. T. , Ugurlu M. Ü. , Boyacioglu Z.

MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES, cilt.21, sa.6, ss.423-428, 2012 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 21 Konu: 6
  • Basım Tarihi: 2012
  • Doi Numarası: 10.3109/13645706.2011.649039
  • Dergi Adı: MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES
  • Sayfa Sayıları: ss.423-428

Özet

Introduction: As a complement to standard laparoscopy, single incision laparoscopic cholecystectomy (SILS) is gaining popularity. We report our technique and our initial experience with transumbilical multi-port laparoscopic cholecystectomy (TUMP-LC) without an access device, with standard laparoscopic instruments, and report the clinical outcomes. Material and methods: Twenty-five (23 F: 2 M) consecutive patients with symptomatic cholelithiasis were included. The surgical outcomes such as length of stay, complications and perioperative morbidity were analyzed. For evaluation of surgical stress preoperative and postoperative C-reactive protein (CRP) values at 6 h and 24 h were measured. Postoperative pain was evaluated using a standard 10-point visual analogue scale (VAS). Results: The mean duration of the surgery was 44.56 minutes (range, 18-110). Additional trocars were needed in two (8%) cases. Mean pain scores post-operatively at 4 h, 12 h and 24 h were 4 +/- 1.19, 3.64 +/- 1.03 and 2.24 +/- 0.96, respectively (p < 0.0001). Plasma CRP values increased at 6 h and started to decrease at 24 h (p < 0.0001). None of the cases were converted to open surgery and no major complications occurred. Discussion: TUMP-LC using standard laparoscopic instrumentation without an access device is an effective alternative to standard four-incision laparoscopic cholecystectomy. Our technique maintains the principles of the conventional procedure and the instrumentation, but also improves the access.