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WJOLS
Scarless Cholecystectomy with Standard Laparoscopic Instruments in Selected Patients
A D A C
B E B D
Figs 5A to D: (A) Irrigation and suction and control of hemostasis,
(B and C) gallbladder extraction through supraumbilical port,
(D) result of scarless cholecystectomy
cholecystectomy performed with standard instruments is
technically feasible and safe. It also provides good cosmetic
result. Further validation of these approaches, however, awaits
randomized clinical trials and accurate comparison with outcomes
C F
of the more conventional approaches.
Figs 3A to F: (A and B) Dissection of cystic pedicle, (C) clipping of
anteriorly located cystic artery, (D) ensuring the anatomy of cystic
duct, (E) application of Hem-o-lok clips overcystic duct, (F) cutting of ACKNOWLEDGMENTS
cystic duct
The author thank the staff of operating room (number one) of
Imam Khomeini Hospital, Tehran, Iran for their cooperation.
REFERENCES
1. Poon CM, Chan KW, Lee DW, Chan KC, Ko CW, Cheung HY,
et al. Two-port versus four-port laparoscopic cholecystectomy.
Surg Endosc 2003;17:1624-27.
2. Varadarajulu S, Tamhane A, Drelichman ER. Patient perception
of natural orifice transluminal endoscopic surgery as a technique
A C
for cholecystectomy. Gastrointest Endosc 2008;67:854-60.
3. Bucher P, Pugin F, Buchs N, Ostermann S, Charara F, Morel P.
Single port access laparoscopic cholecystectomy (with video).
World J Surg 2009;33:1015-19.
4. Romanelli JR, Earle DB. Single-port laparoscopic surgery: An
overview. Surg Endosc 2009;23:1419-27.
5. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. One-
wound laparoscopic cholecystectomy. Br J Surg 1997;84:695.
6. Piskun G, Rajpal S. Transumbilical laparoscopic cholecystec-
B D
tomy utilizes no incisions outside the umbilicus. J Laparoendosc
Figs 4A to D: (A and B) Changing the position of second traction Adv Surg Tech A 1999;9:361-64.
stitch to epigastric area in order to facilitate the dissection (C and D). 7. Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G,
Dissection of gallbladder from its bed Terrosu G, et al. Elective transumbilical compared with standard
laparoscopic cholecystectomy. Eur J Surg 1999;165:29-34.
CONCLUSION 8. Cuesta MA, Berends F, Veenhof AA. The invisible
As mentioned above, descriptive studies and at least one cholecystectomy: A transumbilical laparoscopic operation
without a scar. Surg Endosc 2008;22:1211-13.
randomized clinical trial showed that patients experience less 9. Romanelli JR, Mark L, Omotosho PA. Single port laparoscopic
postoperative pain and discomfort and faster recovery by these cholecystectomy with the TriPort system: A case report. Surg
less invasive techniques. 1-9 Our modification of scarless Innov 2008;15:223-28.
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