Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Gastrointestinal Surgery

Background:

• Minimizing port site incisions in laparoscopic cholecystectomy may alleviate postoperative pain.
• Assessing the impact of reduced trocar size on patient outcomes is crucial for surgical advancement.

Purpose of the Study:

• To compare the efficacy of microlaparoscopic cholecystectomy (3.5-mm trocars) versus traditional laparoscopic cholecystectomy (10-mm and 5-mm trocars) in terms of incisional pain and cosmetic results.
• To evaluate other postoperative outcomes including fatigue, nausea, vomiting, and pulmonary function.

Main Methods:

• A double-blind, randomized controlled study involving 60 patients undergoing cholecystectomy.
• Patients were assigned to either microlaparoscopic cholecystectomy (3.5-mm LC) or traditional laparoscopic cholecystectomy (LC).
• Postoperative pain, fatigue, nausea, vomiting, pulmonary function, and cosmetic results were systematically recorded and analyzed.

Main Results:

• Data from 52 patients were analyzed; 3.5-mm LC significantly reduced incisional pain in the first postoperative week compared to LC (p <0.01).
• Supraumbilical port site pain was higher in both groups, but cosmetic results were significantly better with 3.5-mm LC (p <0.01).
• No significant differences were observed in fatigue, nausea, vomiting, or pulmonary function between the groups.

Conclusions:

• The use of 3.5-mm trocars for microlaparoscopic cholecystectomy is a feasible and safe surgical approach.
• Microlaparoscopic cholecystectomy effectively reduces incisional pain and enhances cosmetic outcomes following gallbladder removal.
• Smaller trocar sizes offer a significant advantage in patient recovery and aesthetic results after laparoscopic cholecystectomy.