Initial Experience With a Modified Mini Laparoscopic Technique for Cholecystectomy

Introduction: The use of smaller instruments in laparoscopic cholecystectomy has been well described in a number of trials, but the range of patients in which this minimalist technique can be used in is narrow. Here, we report on the use of a modified mini laparoscopic cholecystectomy in a range of patients with variable BMI’s. 


Methods: Patients with BMI < 35 were consented for mini laparoscopic cholecystectomy . A 10 mm umbilical/camera port was placed using direct visualization and a pneumoperitoneum was achieved. Additional 2mm ports were placed laterally and one below the subxyphoid process. (Note: The 2 mm sites did not have a traumatic canula, but rather allowed the instrument to be introduced through the incision). Patient satisfaction and right-sided abdominal pain was evaluated using a standardized VAS score. 


Results: A mini-laparoscopic technique was undertaken in n=12 patients requiring cholecystectomy. Additionally, a control group of n=12 patients was selected to undergo traditional laparoscopic cholecystectomy. Initial post-op evaluation at 1 week demonstrated that patients who underwent the modified mini technique were generally less tender on the right side and were more satisfied using a validated VAS score. There was no difference among patients requiring cholecystectomy for acute cholecystitis, biliary dyskensia, or cholelithiasis. 


Conclusions: This case series highlights the exclusive use of a new hybrid mini-laparoscopic technique for cholecystectomy. We have found that this technique, unlike purely mini laparoscopic cholecystectomy proves to be an option that can be offered to a wider variety of patients with very little learning curve transition for the operating surgeon. 

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