Long-term follow up of a new, hybrid technique for mini-laparoscopic cholecystectomy: Implications for the community-based surgeon

Florias A Morfesis, MD, FACS, Brian P Rose, BS

Owen Drive Surgical Clinic of Fayetteville

Introduction: The use of mini-laparoscopy cholecystectomy has been previously well described; however its application in a community-based setting can be regarded as inefficient. These abstract reports on long-term follow-up data from a previous case series on a modified hybrid technique for cholecystectomy.

Methods: Patients with BMI < 35 were consented for a hybrid 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. Patient satisfaction and right-sided abdominal pain was evaluated using a standardized VAS score. Long-term follow-up was maintained at 1 year.

Results: A hybrid 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. Additional follow-up was done at 1 year through chart review and found no evidence of complications or limitations to cosmesis.

Conclusions: This case series is the first of its kind to not only report on a hybrid approach to mini-laparoscopic cholecystectomy, but to report long-term efficacy. We believe that this hybrid approach is optimal for the average community surgeon and its application can be applied to a variety of patients with a minimal learning curve.

Session: Poster Presentation

Program Number: P391

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