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Single-access transumbilical laparoscopic appendectomy and cholecystectomy using new curved reusable instruments: a
Giovanni Dapri1, Lorenzo Casali, Hélène Dumont
1Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, 322, Rue Haute, 1000 Brussels, Belgium. giovanni@dapri.net
Surgical Endoscopy
|September 3, 2010
Summary
Single-access transumbilical laparoscopic appendectomy (SATLA) and cholecystectomy (SATLC) offer a safe, minimally invasive approach. New curved reusable instruments facilitate ergonomic surgery with comparable costs to standard laparoscopy.
Area of Science:
- Minimally Invasive Surgery
- Surgical Instrumentation
- Gastrointestinal Surgery
Background:
- The umbilicus serves as a natural port for single-access laparoscopic surgery.
- New curved reusable instruments have been developed for transumbilical procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of single-access transumbilical laparoscopic appendectomy (SATLA) and cholecystectomy (SATLC).
- To assess the utility of novel curved reusable instruments in these procedures.
Main Methods:
- A retrospective review of 50 patients (30 SATLA, 20 SATLC) between May and November 2009.
- Procedures utilized an 11-mm umbilical trocar for scope and transumbilical curved instruments without additional trocars.
- Outcome measures included operative time, scar length, complications, hospital stay, and pain medication use.
Main Results:
- No extraumbilical trocars were required for any procedure.
- Mean operative times were 57.3 min for SATLA and 73.9 min for SATLC.
- Mean scar lengths were 14.8 mm (SATLA) and 15.8 mm (SATLC), with minimal pain medication use and short hospital stays.
Conclusions:
- SATLA and SATLC are safe and feasible using curved reusable instruments.
- These instruments enable ergonomic operating and prevent instrument clashing.
- The cost of using reusable instruments is comparable to conventional laparoscopy.