BACKGROUND: New techniques for laparoscopic cholecystectomy (LC) that reduce the number of trocars or use very thin instruments have been devised with the goal of further minimizing surgical invasiveness. METHODS: We performed two-trocar LC using an original new technique in 70 consecutive patients. A 10-mm trocar and a 5-mm trocar were inserted in the subumbilical and epigastrium positions, respectively. A 2-mm grasper forceps was inserted directly without a trocar below the costal margin. The fundus of the gallbladder was ligated and lifted up with a folded 0 silk string and a 16-gauge vessel cannula. RESULTS: The mean operative time was 73.2 +/- 23.5 min. A third trocar was added in two cases. None of the patients required conversion of the procedure to an open cholecystectomy, and there were no intraoperative complications. CONCLUSION: Based on our experience, we think that this technique is as safe and effective as the classic four-trocar technique; moreover, it has a cost benefit.
BACKGROUND: New techniques for laparoscopic cholecystectomy (LC) that reduce the number of trocars or use very thin instruments have been devised with the goal of further minimizing surgical invasiveness. METHODS: We performed two-trocar LC using an original new technique in 70 consecutive patients. A 10-mm trocar and a 5-mm trocar were inserted in the subumbilical and epigastrium positions, respectively. A 2-mm grasper forceps was inserted directly without a trocar below the costal margin. The fundus of the gallbladder was ligated and lifted up with a folded 0 silk string and a 16-gauge vessel cannula. RESULTS: The mean operative time was 73.2 +/- 23.5 min. A third trocar was added in two cases. None of the patients required conversion of the procedure to an open cholecystectomy, and there were no intraoperative complications. CONCLUSION: Based on our experience, we think that this technique is as safe and effective as the classic four-trocar technique; moreover, it has a cost benefit.
Authors: Paul G Curcillo; Andrew S Wu; Erica R Podolsky; Casey Graybeal; Namir Katkhouda; Alex Saenz; Robert Dunham; Steven Fendley; Marc Neff; Chad Copper; Marc Bessler; Andrew A Gumbs; Michael Norton; Antonio Iannelli; Rodney Mason; Ashkan Moazzez; Larry Cohen; Angela Mouhlas; Alex Poor Journal: Surg Endosc Date: 2010-02-05 Impact factor: 4.584