Modified three port laparoscopic cholecystectomy versus conventional four port technique

Authors

  • Ritvik Resutra Department of Forensic Medicine and Toxicology, Government Medical College, Bakshi Nagar, Jammu, Jammu and Kashmir, India
  • Rajive Gupta Department of Surgery, Government Medical College, Bakshi Nagar, Jammu, Jammu and Kashmir, India
  • Madhu Gupta Department of Radio Diagnosis and Imaging, Government Hospital, Gandhi Nagar, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20202276

Keywords:

Cholelithiasis, Cholecystectomy, Modified, Pneumoperitoneum, Ports, Trocar

Abstract

Background: The current  study was undertaken to compare the results of modified three-port laparoscopic cholecystectomy and conventional three or four-port surgery in terms of technical feasibility, safety of the technique, postoperative pain and need of post-operative analgesia, cosmetic satisfaction of the patient and cost effectiveness and were found to be better with the modified technique.

Methods: In modified three port laparoscopic cholecystectomy technique, first 10 mm umbilical, second 5 mm epigastric and third 5 mm subcostal ports are made, i.e., "10-5-5" instead of "10-10-5" or "10-10-5-5" of conventional three or four port techniques and finally, gallbladder is extracted through the umbilical port.

Results: The pain in the postoperative period and the requirement of postoperative analgesia were significantly less and there was better cosmetic satisfaction of the patients operated by the modified three port laparoscopic cholecystectomy technique as compared to conventional three or four port surgery.

Conclusions: The modified three-port laparoscopic cholecystectomy technique is safe and has the same comfort and feasibility to the surgeon along with added advantage of less pain and better cosmetic appearance to the patient in comparison to the conventional three or four-port surgery, with no obvious increase in complications and is definitely a viable alternative procedure for the management of cholelithiasis.

References

Beal JM. Historical perspective of gallstone disease. Surg Gynecol Obstet. 1984;158(2):181.

McSherry CK. Cholecystectomy: the gold standard. Am J Surg. 1989;158:174-8.

McDermott EWM, O’Dwyer JJ, Murphy JJ, O’Higgins N. Randomised trial of mini-cholecystectomy versus standard cholecystectomy. Int Surg Week Stockholm. 1991:153.

Dubois F, Icard P, Berthelot GA, Levard H. Coelioscopic cholecystectomy. Preliminary report of 36 cases. Anna Surg. 1990;211(1):60.

Litynski GS, Mouret, Dubois, Perissat. The laparoscopic breakthrough in Europe (1987-1988). J Soc Laparoendoscop Surg. 1999;3(2):163.

Udwadia TE, Patil SU, Udwadia RT, Bhandarkar DS. Laparoscopic cholecystectomy in India. Int Surg. 1992;77(3):149-53.

Haribhakti SP, Mistry JH. Techniques of laparoscopic cholecystectomy: Nomenclature and selection. J Minim Access Surg. 2015;11(2):113-8.

McCormack D, Saldinger P, Cocieru A, House S, Zuccala K. Micro-laparoscopic cholecystectomy: an alternative to single port surgery. J Gastrointest Surg. 2011;15(5):758-61.

Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J. Microlaparoscopic vs conventional laparoscopic cholecystectomy. Surg Endoscop Other Intervent Tech. 2002;16(3):458-64.

Huang MT, Wang W, Wei PL, Chen RJ, Lee WJ. Minilaparoscopic and laparoscopic cholecystectomy: a comparative study. Arch Surg. 2003;138(9):1017-23.

Yuan RH, Lee WJ, You SC. Mini-laparoscopic cholecystectomy: cosmetically better, almost scarless procedure. J Laparoendosc Adv Surg Tec. 1997;7(4):205-11.

Franklin ME, George J, Russek K. Needlescopic cholecystectomy. Surg Technol Int. 2010;20:109-13.

Leggett PL, Bissell CD, Churchman-Winn R, Ahn C. Minimizing ports to improve laparoscopic cholecystectomy. Surg Endosc. 2001;15(3):293-6.

Cala Z, Perko Z, Velnić D. Comparison of the results of laparoscopic cholecystectomy preformed in the usual way and with a lesser number of trocars. Lijecnicki Vjesnik. 2000;122(1-2):1-5.

Sun S, Yang K, Gao M, He X, Tian J, Ma B. Three- port versus four-port laparoscopic cholecystectomy: meta-analysis of randomized clinical trials. World J Surg. 2009;33(9):1904-8.

Harsha HS, Gunjiganvi M, Singh CA, Moirangthem GS. A study of three-port versus four-port laparoscopic cholecystectomy. J Med Soc. 2013;27(3):208.

Trick S. Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc other Interventional Tech. 2003;17(9):1434-6.

Leggett PL, Bissell CD, Churchman-Winn R, Ahn C. Three-port microlaparoscopic cholecystectomy in 159 patients. Surg Endoscop. 2001;15(3):293-6.

Slim K, Pezet D, Stencl J, Lechner C, Le Roux S, Lointier P, et al. Laparoscopic cholecystectomy: an original three-trocar technique. World J Surg. 1995;19(3):394-7.

Kumar M, Agrawal CS, Gupta RK. Three-port versus standard four-port laparoscopic cholecystectomy: a randomized controlled clinical trial in a community-based teaching hospital in eastern Nepal. JSLS. 2007;11(3):358.

Nafeh AI, Abbas M, Youssef YF, Helmy AH. One surgeon show laparoscopic cholecystectomy through three ports. Egypt J Surg. 2005;24:2.

Al-Azawi D, Houssein N, Rayis AB, McMahon D, Hehir DJ. Three-port versus four-port laparoscopic cholecystectomy in acute and chronic cholecystitis. BMC Surg. 2007;7(1):8.

Cerci C, Tarhan OR, Bart I, Bülbül M. Three-port versus four-port laparoscopic cholecystectomy. Hepato-gastroenterol. 2007;54(73):15-6.

Tavern M, Tuveri A. Laparoscopic cholecystectomy: complications and conversions with the 3-trocar technique: a 10-year review. Surg Laparoscop Endoscop Percutan Tech. 2007;17(5):380-4.

Mayir B, Dogan U, Koc U, Aslaner A, Bılecık T, Ensarı CO, et al. Safety and effectiveness of three- port laparoscopic cholecystectomy. Int J Clin Exp Med. 2014;7(8):2339.

Genc V, Sulaimanov M, Cipe G, Basceken SI, Revered N, Gurel M, et al. What necessitates the conversion to open cholecystectomy?: a retrospective analysis of 5164 consecutive laparoscopic operations. Clin. 2011;66(3):417-20.

Gorini P, Capizzi FD.A three trocar approach to laparoscopic removal of the gallbladder (Letter). J Surgical Laparoscopy Endoscopy. 1997;7:180-1.

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Published

2020-05-26

How to Cite

Resutra, R., Gupta, R., & Gupta, M. (2020). Modified three port laparoscopic cholecystectomy versus conventional four port technique. International Journal of Research in Medical Sciences, 8(6), 2248–2254. https://doi.org/10.18203/2320-6012.ijrms20202276

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Original Research Articles