Introduction: Laparoscopic cholecystectomy remains the most frequently performed minimally invasive operation for general surgeons. The next step toward "scar-less" surgery uses a modified single multichannel port inserted through the umbilicus.
Methods: The use of a single port requires modification of the currently established technique for laparoscopic cholecystectomy with a single-port protocol. This new method presents a few technical difficulties and challenges compared with the conventional 3-port or 4-port laparoscopic cholecystectomy. We discuss maneuvers to help overcome these difficulties based on our initial experiences. All the data for the procedures that were performed were prospectively collected and analyzed.
Results: Single port cholecystectomy was attempted in 30 patients (all females) with no intraoperative/postoperative complications from September 2008 to March 2008. In all, 20 of 30 patients had their operation completed with the use of a single port. An extra 5-mm epigastric port was required in 8 of the 20 patients. Another 2 of 20 patients required conversion of the operation into a standard laparoscopic technique (1x3-port and 1x4-port procedure). All the patients were discharged within 24 hours. There were no intraoperative or postoperative complications or mortalities.
Conclusions: The single-port technique is feasible for performing routine laparoscopic procedures. With further advances in surgical technique, technology, and instrumentation, this technique can be reproduced to perform more complex biliary and other procedures in future.
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http://dx.doi.org/10.1097/SLE.0b013e3181ca7ff1 | DOI Listing |
Int J Surg Case Rep
January 2025
University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Introduction: Duplication of the gallbladder is a rare congenital malformation associated with the development of cholelithiasis. It increases the risk of iatrogenic bile duct injury during cholecystectomy and can lead to symptom recurrence if missed. Although preoperative imaging is helpful, detection rates are around 50 %.
View Article and Find Full Text PDFSurg Endosc
January 2025
Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Avenue, Wuhua District, Kunming, 650106, Yunnan, People's Republic of China.
Background: Gallbladder cholesterol polyp (GCP) and gallbladder adenoma (GA) are easily confused in clinical diagnosis. This study aims to establish a nomogram prediction model for preoperative prediction of the risk of GA patients.
Study Design: We retrospectively collected clinical data of GCP or GA patients who underwent laparoscopic cholecystectomy (LC) between January 2020 and April 2023.
J Am Coll Surg
January 2025
Department of Surgery, Stanford University, Stanford, CA.
Background: Motion-tracking has been shown to correlate with expert and novice performance but has not been used for skill development. For skill development, performance goals must be defined. We hypothesize that using wearable sensor technology, motion tracking outcomes can be identified in those deemed practice-ready and used as benchmarks for precision learning.
View Article and Find Full Text PDFInt J Surg
December 2024
Department of Surgery, Azienda Unità Sanitaria Locale Ferrara, University of Ferrara, Via Valle Oppio, Lagosanto, Ferrara, Italy.
Background: Currently, there is limited scientific evidence regarding the effectiveness of fluorescent cholangiography in emergency cholecystectomy for acute cholecystitis. The primary aim of this study was to assess the efficacy of near-infrared fluorescent cholangiography (NIRF-C) in different severity degrees of acute cholecystitis.
Materials And Methods: Inclusion criteria were patients with a clinical and radiological (abdominal ultrasound and/or computed tomography) diagnosis of acute cholecystitis based on the revised 2018 Tokyo guidelines who underwent laparoscopic cholecystectomy within 24-72 h from the onset of symptoms and patients with ASA score of 0-3.
J Int Med Res
January 2025
Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Monopolar electrocautery is usually a safe and effective technique used in laparoscopic cholecystectomy and bile duct surgery, but it may lead to adverse consequences, even ventricular fibrillation (VF). Amiodarone is an effective antiarrhythmic drug commonly used in practice to treat ventricular and atrial arrhythmias, but it may induce tachyarrhythmia or even VF. We report a case of VF occurring twice during cholecystectomy.
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