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2006, Number 1-4

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Rev Mex Cir Endoscop 2006; 7 (1-4)

Laparoscopic cholecystectomy with instrument-port of 3.5 mm

Dávila ÁF, Jesús SR, Dávila ÁU, Dávila ZMR, Lemus AJ, Montero PJJ

Language: Spanish
References: 41
Page: 19-26
PDF size: 203.52 Kb.


ABSTRACT

Objective: We show a technique of laparoscopic cholecystectomy basically performed with a modality of miniinstrument denominated «Instrument Port of 3.5 mm», with the purpose of improving the aesthetic aspect of the traditional laparoscopic cholecystectomy and to give greater force to the miniinstrument.
Material and methods: From March to June of 1997, 16 patients selected with the diagnosis of non acute cholelithiasis were operated of laparoscopic cholecystectomy with instrument port of 3.5 mm. They were excluded from the technique patient with acute cholecystitis, hydro or piocholecysto, choledocholithiasis or cancer. We analyzed the following variables: age, gender, surgical time, hospital stay, feasibility of the procedure and aesthetic.
Results: The age average was of 39 years, 12 patients female and 4 male. The surgical time average was of 67 minutes, 12 minutes greater than with our traditional technique of laparoscopic cholecystectomy. The hospital stay was of 24 hours. There was conversion in 2 cases to technique of traditional laparoscopic cholecystectomy with a success feasibility of 86%. There was not morbidity nor mortality. The aesthetic aspect improved and there was not instrument damage.
Conclusions: The technique of cholecystectomy with «Instrument Port of 3.5 mm» has better aesthetic results than traditional laparoscopic technique, with only one subxifoideus visible wound of 3.5 mm. There was not rupture or damage on the port instrument in any case in that it was used.


REFERENCES

  1. Reddik EJ, Olsen DO. Laparoscopic laser cholecystectomy. A comparison with mini-lap cholecystectomy. Surg Endosc 1989; 3: 131-3.

  2. Perissat J, Collet D, Belliard R, Desdphautez J, Magne E. Laparoscopic cholecystectomy: the State of the Art. A report of 700 consecutive cases. World Surg 1992; 16: 1074-82.

  3. Gagner M, García Ruiz A. Technical aspects of minimally invasive abdominal surgery performed with needlescopic instruments. Surg Laparosc Endosc 1998; 8(3): 171-9.

  4. Reardon PR, Kamelgard JI, Applebaum B et al. Feasibility of laparoscopic cholecystectomy with miniaturized instrumentation in 50 consecutive cases. World J Surg 1999; 23(2): 128-31.

  5. Reardon PR, Kamelgard JI, Applebaum BA, Brunicardi FC. Mini-laparoscopic cholecystectomy: validating a new approach. J Laparendosc Adv Surg Tech A 1999; 9(3): 227-32.

  6. Kuthe A, Tamme C, Saemann T, Schneider C, Kockerling F. Laparoscopic cholecystectomy with mini-instruments. Technique and initial experiences. Zentralbl Chir 1999; 124(8): 749-53.

  7. Mostafa G, Matthews BD, Sing RF, Kercher KW, Heniford BT. Mini-laparoscopic versus laparoscopic approach to appendectomy. BMC Surgery 2001; 1(1): 4.

  8. Berber E, Berber I, Avtan L, Ata B, Azamak A, Avci C. Laparoscopic vagotomy using mini-instruments in the rat: a new laparoscopic small animal model. Surg Today 2002; 32(6): 498-502.

  9. Leggett PL, Bissell CD, Churchman-Winn R. Cosmetic minilaparoscopic cholecystectomy. Surg Endosc 2001; 15(10): 1229-31.

  10. Mainik F, Flade-Kuthe R, Kuthe A. Laparoscopic appendectomy with mini-instruments. Zentralbl Chir 2003; 128(2): 95-8.

  11. Davides D, Dexter SP, Vezakis A, Larvin M, Moran P, McMahon MJ. Micropuncture laparoscopic cholecystectomy. Surg Endosc 1999; 13(3): 236-8.

  12. Uranus S, Peng Z, Kronberger L, Pfeifer J, Salehi B. Laparoscopic cholecystectomy using 2-mm instruments. J Laparoendosc Adv Surg Tech A 1998; 8(5): 255-9.

  13. De la Torre G. Colecistectomía por vía laparoscópica utilizando instrumental de 2 mm. Cirujano General 1999; 21(3).

  14. Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J. Microlaparoscopic vs conventional laparoscopic cholecystectomy prospective randomized double-blind trial. Surg Endosc 2002; 16(3): 458-64.

  15. Tanaka J, Andoh H, Koyama K. Minimally invasive needlescopic cholecystectomy. Surg Today 1998; 28(1): 111-3.

  16. Ngoi SS, Goh P, Kok K, Kum CK, Cheah WK. Needlescopic or minisite cholecystectomy. Surg Endosc 1999; 13(3): 303-5.

  17. Lai ECS, Fok M, Chan ASH. Needlescopic cholecystectomy: prospective study of 150 patients. Hong Kong Med J 2003; 9(4): 238-42.

  18. Lee BR, Kavoussi LR, Goh PM. Needlescopic surgery. Urology 1999; 53(5): 1071.

  19. Steinhilper U, Bonn S, Kopf S. Microinvasive laparoscopic cholecystectomy with 2 mm instruments. Presentation of the method and initial results. Chirurg 2001; 72(1): 1-5.

  20. Dávila F, Dávila U, Montero J, Lemus J, López Atzin F, Villegas J. Colecistectomía laparoscópica com un solo puerto visible subxifoideo de 5 mm. Rev Mex Cirugía Endoscópica 2001; 2(1): 16-20.

  21. Dávila F, Aditamentos útiles en cirugía minilaparoscópica. Cirugía sin huella. México. Edit UNAM-FES Iztacala 2002: 87-94.

  22. Dávila F. Colecistectomía con el Puerto-Instrumento (3.5 mm). Cirugía sin Huella. México. Editorial UNAM-FES Iztacala. 2002: 59-64.

  23. Cala Z. Laparoscopic cholecystectomy: an original three-trocar technique. World J Surg 1995; 20(1): 117-8.

  24. Tagaya N, Kita J, Takagi K, Imada T, Ishikawa K, Kogure H, Ohyama D. Experience with three-port laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg 1998; 5(3): 309-11.

  25. Leggett PL, Bissell CD, Churchman-winn R, Ahn C. Three-port microlaparoscopic cholecystectomy in 159 patients. Surg Endosc 2000; 15(3): 293-6.

  26. Endo S, Souda S, Nezu R, Yoshikawa Y, Hashimoto J, Mori T. A new method of laparoscopic cholecystectomy using three trocars combined with suture retraction of gallbladder. J Laparoendosc Adv Surg Tech A 2001; 11(2): 85-8.

  27. Mori T, Ikeda Y, Okamoto K, Sakata K, Ideguchi K, Nakagawa K, Yasumitsu T. A new technique for two-trocar laparoscopic cholecystectomy. Surg Endosc 2002; 16(4): 589-91.

  28. Kagaya T. Laparoscopic cholecystectomy via two ports, using the «twin-system». J Hepatobiliary Pancreat Surg 2001; 8(1): 76-80.

  29. Lomanto D, De Angelis L, Ceci V, Dalsasso G, So J, Frattaroli FM, Mu R, Speranza V. Two-trocar laparoscopic cholecystectomy: a reproducible technique. Surg Laparosc Endosc Percutan Tech 2001; 11(4): 248-51.

  30. Ramachandran CS, Arora V. Two-port laparoscopic cholecystectomy: an innovative new method for gallbladder removal. J Laparoendosc Adv Surg Tech A 1998; 8(5): 303-8.

  31. Leung K, Lee K, Cheung T, Lau K. Laparoscopic cholecystectomy: two port technique. Endoscopy 1996; 28(6): 505-7.

  32. Poon CM, Chan KW, Ko CW, Chan KC, Lee DW, Cheung HY, Lee K. Two-port laparoscopic cholecystectomy: initial results of a modern technique. J Laparoendosc Adv Surg Tech A 2002; 12(4): 259-62.

  33. Piskun G, Rajpal S. Transumbilical laparoscopic cholecystectomy utilizes no incision outside the umbilicus. J Laparoendosc Adv Surg Tech A 1999; 9(4): 361-4.

  34. Mathias J. Needlescopic surgery is painless and scarless. Or Manager 1997; 13(11): 26-7.

  35. Mamazza J, Schlachta CM, Seshadri PA, Cadeddu MO, Poulin EC. Needlescopic surgery. A logical evolution from conventional laparoscopic surgery. Surg Endosc 2001; 15(10): 1208-12.

  36. Yeung CK. Needlescopic operation: surgery of the future? Hong Kong Med J 20-03. 9(4): 236-7.

  37. Mar Fan M, Chan S. Needlescopic (mini-laparoscopic) surgery: necessary or unnecessary. Aust N Z Surg 1998; 68(9): 628-9.

  38. Yuan R, Lee W, Yu S. Mini-laparoscopic cholecystectomy: a cosmetically better, almost scarless procedure. J Laparoendosc Adv Surg Tech A 1997; 7(4): 205-11.

  39. Dávila F. Colecistectomía laparoscópica con un puerto. Cirugía Sin Huella. México. Edit. UNAM-FES Iztacala. 2002: 113-122.

  40. Dávila F, Weber A, Dávila U, Lemus J, López J, Reyes G, Domínguez V. Laparoscopic cholecystectomy with only one port (with no trace): a new technique. Scientific Session Abstracts SAGES March 1999; S29: 58.

  41. Dávila F, Weber A, Chousleb A, Gutierrez L, Lemus J, López J, Gomez de Arteche J, Ledesma L. Minilaparoscopic Surgery with only one port (without trace). Scientific Session Abstracts SAGES March 1999; 131: 80.




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