2013, Number 3
Experience in the use of minilaparoscopy at the ABC Medical Center
Moreno PEF, Aragón LA, Toledo C, Arrangoiz R, Cordera F, Luque E, Muñoz M
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Language: Spanish
References: 10
Page: 114-118
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ABSTRACT
Minilaparoscopy (MINI) is an advance of conventional laparoscopic surgery (CLC) that utilizes surgical instrument 3 mm in caliber. It produces a cosmetic outcome similar to the one obtained by natural orifice trasendolumenal endoscopic surgery (NOTES), and a more aesthetic wound that the one obtained by single-port laparoscopic surgery (SILS/LESS), while preserving the safety principles CLS has proven through the years. The use of low-friction ports produces less abdominal wall trauma that reflects in less postoperative pain, shorter hospital stay and also shorten the time to a full recovery. Objective: To report the initial experience with the use of Minilaparoscopy at the ABC Medical Center in Mexico City. Methods: We conducted an observational, retrospective, descriptive study including patients that underwent minilaparoscopic surgical procedures at the ABC Medical Center during a 2 year period. Sex, age, type of procedure, operative time (TQ), bleeding (ST), complications and rate of convertion to CLS or open surgery were registered. Regarding type of procedure, we performed appendectomies (MINI-AL), cholecystectomy (MINI-CL), inguinal hernia repair (MINI-PI), and fundoplicature (MINI-FN). Variables were collected in our data base and were analyzed using central tendency measures. We included patients that were submitted to mini-laparoscopic procedures from May, 2012 to August, 2014. Patients which did not have a complete medical record or lack of study variables were excluded. All procedures were undertaken by a single surgeon. Results: A total of 60 patients conformed the study group (H: 66.6%; M: 33.3%) with a mean age of 44.76 years old (±15.8). These patients underwent the following procedures: MINI-AL (n = 17), unilateral MINI-PI (n = 5), bilateral MINI-PI (n = 10), MINI-FN (n = 10), y MINI-CL (n = 18). Mean operative time and bleeding were reported as follows: MINI-AL (TQ = 48.52 minutes; ST = 30 mL), unilateral MINI-PI (TQ = 53 minutes; ST = 40 mL), bilateral MINI-PI (TQ = 107.5 minutes; ST = 60 mL), MINI-FN (TQ = 139 minutes; ST = 34.4 mL), MINI-CL (TQ = 83.2 minutes; ST = 38.28 mL. In 5 MINI-LC there was a substitution of a 3 mm MINI-trocar for a standard 5 mm trocar to evacuate some cloths. There were no complications and no conversions to CLS or open surgery whatsoever. One patient was submitted to MINI- CL and MINI-FN during the same surgical time. Conclusion: MINI has proven to be a safe, efficient and precise technique with the advantages of minimal-access or reduce-port procedures such as less surgical damage to the abdominal wall, while preserving safety principles of CLS. As a colateral effect, the cosmetic outcome of MINI is comparable to the one obtained by NOTES and SILS/LESS due to occult or diminute wounds.REFERENCES