Page 45 - World Journal of Laparoscopic Surgery

RESEARCH ARTICLE
Technical Report: A Modification in Laparoscopic

Cholecystectomy Technique for Left-handed Surgeons

1
2
Alireza Tavassoli , Seyed Hassan Babaee , Maryam Asgarian Yazdi 3
AbstrAct
Introduction: Studies show very few articles addressed left-handed surgeons and their problems. Difficulties occur in using the tools and
methods that have been invented by right-handed surgeons. Some previous studies have shown that surgical left-handed residents have much
less skilled hands. This study aims to describe some changes that were made that led to 40 safe and comfortable cholecystectomy procedures.
Materials and surgical technique: The most important changes compared to the standard method are about trocar placing to improve
alignment for a left-handed surgeon.
Result: Forty surgeries using the modified methods were done and in comparison to the standard method were much smoother, faster, and
with fewer side effects.
Discussion: By our modification left-handed surgeons can improve their safety and their comfort during operations and expand their skills in
this regard.
Keywords: Laparoscopic cholecystectomy, Left-handed surgeon, Technical modification.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1441

IntroductIon
1–3 Endoscopic and Minimally Invasive Surgery Research Center,
Studies show very few articles addressed left-handed surgeons Mashhad University of Medical Sciences, Mashhad, Iran
1
and their problems so far. Difficulties occur in using the tools and Corresponding Author: Seyed Hassan Babaee, Endoscopic and
methods that have been invented by right-handed surgeons. While Minimally Invasive Surgery Research Center, Mashhad University of
8% of the human population is left-handed, in this case very limited Medical Sciences, Mashhad, Iran, Phone: +98 5138012806, Fax: +98
2
information is available. Previous studies have shown that many 5138417452, e-mail: emis@mums.ac.ir.
surgical left-handed residents have much less skilled hands to the How to cite this article: Tavassoli A, Babaee SH, Yazdi MA. Technical
extent that they quit this field. 3 Report: A Modification in Laparoscopic Cholecystectomy Technique
This study aims to describe and show some changes were made for Left-handed Surgeons. World J Lung Surg 2021;14(1):46–47.
by a left-handed surgeon that has led to safe and comfortable Source of support: Nil

cholecystectomy in comparison with the standard 4-port method Conflict of interest: None
at Ghaem Educational and Treatment hospital in Mashhad.

MAterIAls And surgIcAl technIque place so that the new trocar location can improve alignment with
In the standard method, the patient is placed supine on the the left hand of the surgeon and through which the surgeon will
operating table with the surgeon standing at the patient’s left side. be able to guide the dissector tool easily and without interference
A 10-mm trocar is inserted through the supraumbilical incision. The with the cameraman. And with his right hand from subxiphoid can
laparoscope with the attached video camera is passed through provide adequate exposure. The next trocar is optional. According
the umbilical port and the abdomen inspected. Three additional to the anatomy of the gallbladder, its presence and absence is
ports are placed under direct vision. A 10-mm port is placed in the determined. As the standard method, it is a 5-mm trocar placed
epigastrium, a 5-mm port in the middle of the clavicular line, and on the midaxillary line about the umbilicus (Fig. 1).
a 5-mm port in the right flank, in line with the gallbladder fundus. 4
The most important changes compared to the standard
method are about trocar placing. Like the standard method, the
left-handed surgeon stands on the left side of the patient and the
first aid stand beside him and the monitor to be placed on the right
side in front of the surgeon. Initially, a 10-mm trocar is placed in the
umbilicus to enter the camera. The next is a 5-mm trocar placed
in the epigastrium and subxiphoid. The most important change is
done in the third step where a 10-mm trocar is placed in the left Fig. 1: (A) Standard trocar replacement by a right-handed surgeon in
paramedian between the umbilicus and sub coastal border on American style. (B) Our modified trocar replacement for a left-handed
the midclavicular line. The biggest change has been created in its surgeon in American style

© Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons
Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.