Transumbilical Multiple-port Laparoscopic Cholecystectomy Using Standard Laparoscopic Instruments

M. Tahir Oruc, MD, M. Umit Ugurlu, MD, Zehra Boyacioglu, MD. KOCAELI DERINCE TEACHING AND RESEARCH HOSPITAL GENERAL SURGERY CLINIC

 

Introduction: As a complement to standard laparoscopy, SILS is gaining popularity. We reported our technique and our initial experience with TUMP-LC without an access device using standard laparoscopic instruments, together with its clinical outcomes.
Material and Methods: Twenty-five (23 F: 2 M) consecutive patients with symptomatic cholelithiasis were involved. The surgical outcomes such as length of stay, complications and perioperative morbidity were analyzed. For evaluation of surgical stress preoperative and postoperative CRP values at 6 h and 24 h were measured. Postoperative pain was evaluated using a standard 10-point visual analogue scale (VAS).
Results: The mean age of the patients was 47.72 years (range, 22-72); mean BMI of the patients was 28.64 kg/m2 (range, 19.5-39.6). Mean duration of the surgery was 44.56 minutes (range, 18-110). Additional trocars were needed in 2 (8%) cases. Mean pain scores post-operatively at 4 h, 12 h and 24 h were 4 ± 1.19, 3.64 ± 1.03 and 2.24 ± 0.96, respectively (p< 0.0001). Plasma CRP values increased at 6 h and started to decrease at 24 h (p< 0.0001). None of the cases were converted to open and no major complications occurred.
Discussion: TUMP-LC using standard laparoscopic instrumentation without an access device is an effective alternative to standard four-incision laparoscopic cholecystectomy. Our technique maintains the principles of conventional procedure and the instrumentation, but also improves the access.


Session Number: Poster – Poster Presentations
Program Number: P369
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