Page 14 - WJOLS - Journal of Laparoscopic Surgery

WJOL
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WJOLS

10.5005/jp-journals-10033-1314
Two-port Mini LC vs Conventional Four-port vs Single-incision LC
REVIEW ARTICLE

Two-port Mini vs Conventional Four-port vs Single-

incision Laparoscopic Cholecystectomy: An Update with
Review of Literature

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1 Mohammad O Tabrez, Rajneesh K Mishra, Jatinder S Chowhan
3
ABSTRACT Source of support: Nil
Introduction: Laparoscopic cholecystectomy (LC) is the gold Conflict of interest: None
standard for the removal of gallbladder stones. In an attempt
to reduce the invasiveness of the procedure, surgeons have
done various modifications like reduction of port size and/or INTRODUCTION
number, which is used in conventional LC. The main objective Laparoscopic cholecystectomy is now the gold standard
of this review is to compare the two-port mini LC with other 1
techniques of LC like conventional four-port laparoscopic for the removal of gallbladder. The main advantages
surgery or single-incision laparoscopic cholecystectomy (SILC) of laparoscopic surgery include better cosmetic results,
in elective laparoscopic cholecystectomy and determine the decreased postoperative pain, and faster functional
outcome of two-port mini LC. recovery. Various innovations in the techniques of LC
1
2
Material and methods: Literature review was performed on like natural transluminal endoscopic surgery, single-
6
newly minimal invasive approach for LC, two-port cholecys- incision laparoscopic surgery (SILS), 3-5 two-port, and
tectomy, variations in size and port of cholecystectomy and three-port laparoscopic surgeries have been applied for
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their advantages over one another, and SILC. The search was removal of gallbladder as a step forward to even lesser
performed using the search engines like Google, PubMed.
invasive procedures than the conventional four-port
Results: Postoperative pain was significantly low in the two- surgery. These different newer techniques represent the
port group. The overall analgesia requirements and return to
daily activity were significantly lower in two-port group. The advent of essentially scarless, more pain-free, better cos-
cosmesis score of the two-port group was better than four- mesis, and early return of function for the patient with
port group or SILC. However, the length of hospital stay and benefit to one another.
complications was similar between the two-port and four-port The evolution of surgery of gallbladder from Lan-
LC, but it differs in SILC. genbuch’s first cholecystectomy with a hospital stay of
Conclusion: Two-port mini LC resulted in reduced pain, need 6 weeks into a day-care specialty following the introduc-
for analgesia, and improved cosmesis without increasing the tion of LC is indeed fascinating. 8
operative time and complication rates compared with that in In conventional four-port LC, one 10-mm optical port
four-port LC or SILC. Hence, two-port mini LC can be tried firstly
and can be converted to additional four-port LC when necessary. is placed in umbilical area and other 10-mm port is to be
placed in the epigastrium to the left of the falciform liga-
Keywords: Cholecystectomy, Laparoscopic cholecystectomy, ment with two additional 5-mm ports in the right upper
Lapchole, Mini-laparoscopy, Review, Single-incision laparo-
scopic cholecystectomy, Two-port laparoscopy. abdomen two finger breadths below the costal margin in
midclavicular line and anterior/midaxillary line at the
How to cite this article: Tabrez MO, Mishra RK, Chowhan JS. level or just below the umbilicus. Dissection of the gall-
Two-port Mini vs Conventional Four-port vs Single-incision
Laparoscopic Cholecystectomy: An Update with Review of bladder is performed by the standard technique by first
Literature. World J Lap Surg 2017;10(3):95-97. grasping and lifting the fundus, followed by dissection of
the cystic duct and artery. Once the “critical view” of these
structures was obtained, these were clipped and divided.
2,3
1 Consultant, Senior Consultant The gallbladder is then removed from its bed using elec-
1 Department of Laparoscopic and Robotic Surgery, Rahmania trocautery and retrieved through the epigastric port.
Medical Centre, Motihari, Bihar, India
2,3 Department of Laparoscopic and Robotic Surgery, World FOREWORD TO LITERATURE REVIEW
Laparoscopy Hospital, Gurugram, Haryana, India
Four-port LC
Corresponding Author: Mohammad O Tabrez, Consultant
Department of Laparoscopic and Robotic Surgery, Rahmania Four-port laparoscopic surgery is also called as conven-
Medical Centre, Motihari, Bihar, India, Phone: +917070990616
e-mail: tabrezomar@gmail.com tional laparoscopic surgery (CLC) for cholecystectomy
performed with fourth port; 10-mm ports are placed at
World Journal of Laparoscopic Surgery, September-December 2017;10(3):95-97 95