Two Port Laparoscopic Cholecystectomy Using 10 Mm Umblical Port and 5 Mm Epigastric Port With Standard Instruments

Dp Singh, MBBSMS, Ashwani Kumar. Government Medical College and Rajindra Hospital, Patiala. India

Ever since the advent of Laparoscopic Cholecystectomy, where in, it has established itself as the Gold Standard in the management of Gall Bladder disease, the effort has been to decrease the size of the incisions and the number of the ports . This is based on the fact that port site complications are directly proportional to the incision size and their number.

We, From Department of Surgery, Medical College Patiala, Punjab, India, will be presenting our technique of doing Laparoscopic Cholecystectomy using 10 mm transumblical Camera port and 5 mm epigastric operating port .

We use two Traction sutures, one at the fundus and the other at the Hartmann’s Pouch to open the subhepatic space and the Calots Triangle . The dissection is more or less similar to the standard Laparoscopic Cholecystectomy. Instead of Liga Clips we use Extracorporeal knotting for handling of the Cystic duct and the Cystic Artery . We also use energy source for tackling the Cystic Artery in some cases to save time. The specimen is delivered in a bag retrograde through the camera port.

We have experience of over 500 cases with minimal conversion rate ( 3 % ) to Three or Four Port Laparoscopic Cholecystectomy ( in difficult cases ) .

We have found the requirement of analgesia in these cases is much less, and cosmetic appearance is excellent.

Since this procedure doesn’t require specialised equipments / instruments, we recommend its feasibility for Cholecystectomy.

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