Dolores López, MD1, Miguel Hernández2, Morris E. Franklin Jr, MD2. 1Tecnológico de Monterrey, 2Texas Endosurgery Institute
Introduction: Minimally invasive techniques have revolutionized the art of the surgical practice. The laparoscopic approach to cholecystectomy has become the gold standard and is the most common laparoscopic general surgery procedure worldwide. In an effort to further enhance the advantages of laparoscopic surgery, even less invasive methods have been attempted, including smaller and fewer incisions. The objective of this study was describing our results of 22 years of needlescopic cholecystectomy.
Methods: Since March 1995 all patients that underwent to needlescopic cholecystectomy micro-laparoscopic procedure with instruments of 3 mm were included in this study in a prospective database and the information was analyzed.
Results: Between March 1995 and September 2017, 638 needlescopic cholecystectomies have been done at Texas Endosurgery Institute in San Antonio, Texas by a single surgeon. 86% of the patients were female. The average age was 41.9 (range of 14-82 years old). Average operating time was 59.3 minutes (range of 30-200 minutes). The 200-minute operation required laparoscopic CBD exploration, accounting for the extended time. Average estimated blood loss (EBL) was 15 cc (range of 5-50 cc). 2% of cases required conversion to standard 5 mm cholecystectomy and was completed without incidents. All patients were followed up at 2 weeks, 4 weeks, and 6 months after the procedure. Only 1 patient presented with a hernia at the umbilical site. Otherwise no wound, bile duct, bile leak, bleeding or thermal injury complications were identified.
Conclusions: Micro-laparoscopic procedures with 3 mm instruments in this specific procedure of Needlescopic cholecystectomy is safe and feasible, and is a cosmetic alternative to the standard laparoscopic cholecystectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88326
Program Number: P675
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster