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A new technique for two-trocar laparoscopic cholecystectomy
1Department of Surgery, Osaka Prefectural Habikino Hospital, 3-7-1, Habikino, Habikino-City, Osaka 583-8588, Japan.
Background:
New techniques for laparoscopic cholecystectomy (LC) that reduce the number of trocars or use very thin instruments have been devised with the goal of further minimizing surgical invasiveness.
Methods:
We performed two-trocar LC using an original new technique in 70 consecutive patients. A 10-mm trocar and a 5-mm trocar were inserted in the subumbilical and epigastrium positions, respectively. A 2-mm grasper forceps was inserted directly without a trocar below the costal margin. The fundus of the gallbladder was ligated and lifted up with a folded 0 silk string and a 16-gauge vessel cannula.
Results:
The mean operative time was 73.2 +/- 23.5 min. A third trocar was added in two cases. None of the patients required conversion of the procedure to an open cholecystectomy, and there were no intraoperative complications.
Conclusion:
Based on our experience, we think that this technique is as safe and effective as the classic four-trocar technique; moreover, it has a cost benefit.