Reduced Port Cholecystectomy – A Step Forward in Minimizing Access in Laparoscopic Surgery

Asfar Ali, MS MRCS FNB FIAGES, Parveen Bhatia, MS FRCS FACS, Sudhir Kalhan, MS, Mukund Khetan, MS, Suviraj John, MS MRCS DNB FNB. Institute of MInimal Access, Metabolic & Bariatric Surgery, Sir Ganga Ram Hospital


Background: Various innovations have been described in reducing access in laparoscopic surgery. Most of these are either complex or costly. We describe our technique of Reduced Port Surgery in an effort to overcome these problems.
Methods: In this study, 210 patients underwent Reduced Port Laparoscopic Cholecystectomy. This involved placing the patient in modified lithotomy position with surgeon between the legs and camera assistant sitting on patient’s left. A 12mm Optiview® (Endopath® XCEL™) and a 5mm low-profile trocars were inserted through a 1.8cm incision at umbilicus. A 2.3mm Alligator Grasper (Stryker MiniLap, USA) passed through right hypochondrium allowed a biplanar manipulation of gall bladder. Hepato-cystic triangle was adequately dissected to obtain the critical view of safety before clipping the cystic duct and artery. Specimen was retrieved in endobag and 12mm port closed.
Results: All cases were completed laparoscopically. Additional 5mm ports were placed in 4 patients. One out of the four procedures performed by Fellows in laparoscopic training was converted to conventional four-port laparoscopic cholecystectomy. Overall, mean operative time was 59.4mins. Post operative pain scores were similar to conventional laparoscopic cholecystectomy and most patients were discharged on the first postoperative day. The cosmetic results and patient satisfaction was significantly better with this technique.
Conclusions: Reduced Port Surgery is a valid, useful and a more easily learnt technique to minimize access in laparoscopic surgery providing excellent cosmetic outcome without increasing the cost.

Session Number: Poster – Poster Presentations
Program Number: P344
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