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Feasibility study on single-port access (SPA) laparoscopic cholecystectomy using transanal endoscopic microsurgery
Chit Sun Wong1, William Chia Shing Meng
1Department of Surgery, Our Lady of Maryknoll Hospital and Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.
Summary
Transanal endoscopic microsurgery (TEM) instruments proved feasible for single-port access cholecystectomy in a porcine model. This technique offers potential for minimally invasive gallbladder surgery.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Gastrointestinal Endoscopy
Background:
- Transanal endoscopic microsurgery (TEM) is an established single-port access (SPA) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) technique.
- TEM has been utilized for over twenty years in treating rectal conditions.
Purpose of the Study:
- To evaluate the feasibility of using TEM instruments for cholecystectomy.
- To explore the application of TEM principles in a different surgical field.
Main Methods:
- A feasibility study was conducted on a porcine model.
- Cholecystectomy was performed using articulated TEM instruments via a peri-umbilical approach.
- Three consecutive in vivo porcine models underwent the procedure.
Main Results:
- Single-port access cholecystectomy was feasible using TEM instruments.
- Median operation time was 26.6 minutes.
- Postoperative mean wound length was 3.7 cm, with one gallbladder perforation.
Conclusions:
- TEM instruments and techniques are suitable for SPA cholecystectomy.
- The TEM rectoscope can serve as a reusable single port, though instrument modifications are suggested.