Single-incision laparoscopic cholecystectomy using flexible endoscopy: saline infiltration gallbladder fossa...

Area of Science:

• Minimally Invasive Surgery
• Endoscopic Surgery
• Surgical Techniques

Background:

• Natural orifice translumenal endoscopic surgery (NOTES) promotes development of flexible endoscopic instruments for minimally invasive procedures.
• This study assesses a technique adapted from endoscopic mucosal resection for gallbladder dissection.

Purpose of the Study:

• To evaluate the efficacy of saline injection for creating surgical planes in gallbladder dissection.
• To assess the application of endoscopic mucosal resection techniques in cholecystectomy.

Main Methods:

• Eight patients underwent transumbilical single-incision cholecystectomy using flexible endoscopy.
• Saline (20 ml) was injected into the gallbladder fossa to create a potential surgical space.
• Dissection was performed endoscopically, with clipping of cystic duct and artery via laparoscopic instruments.

Main Results:

• No inadvertent gallbladder perforations occurred in any of the eight patients.
• Saline infiltration significantly improved visualization of the dissection plane between the gallbladder and liver bed.
• Enhanced visualization was observed in all patients undergoing the procedure.

Conclusions:

• Saline injection is an effective method for developing surgical planes in endoscopic cholecystectomy.
• This technique enhances visualization and has potential value for various surgical dissections.
• Further evaluation is recommended to determine the effectiveness of this approach in other applications.