[Laparoscopic cholecystectomy with mini-instruments. Technique and initial experiences].

Area of Science:

• Minimally Invasive Surgery
• Surgical Instrumentation
• Gastrointestinal Surgery

Context:

• Laparoscopic cholecystectomy is a common procedure.
• Mini-instruments offer potential for reduced invasiveness.
• Standardization of techniques is crucial for safety and efficacy.

Purpose:

• To develop and assess a standardized technique for laparoscopic cholecystectomy using mini-instruments.
• To evaluate the feasibility and safety of mini-instruments in this procedure.
• To compare outcomes with standard laparoscopic cholecystectomy.

Summary:

• A prospective study of 60 patients undergoing laparoscopic cholecystectomy with mini-instruments was conducted.
• Initial procedures used a mix of standard and mini-instruments; later procedures utilized more mini-trocars.
• Intraoperative cholangiography was performed using a minilaparoscope.
• One intraoperative complication (bleeding) and three conversions to standard instruments (broken forceps, weak grasping forceps) occurred.
• No postoperative complications were observed, with a mean operating time of 62.4 minutes.

Impact:

• Mini-instruments are feasible for elective laparoscopic cholecystectomy in slim patients, with acceptable operating times and no increased complication risk.
• Current limitations in mini-instrument properties and mini-laparoscope optical quality preclude general recommendation.
• Further development of mini-instrument technology is needed for broader clinical adoption.