Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

Area of Science:

• Minimally Invasive Surgery
• Surgical Instrumentation

Background:

• Single-incision laparoscopic cholecystectomy (SILS) aims to reduce surgical trauma and improve cosmetic outcomes.
• Conventional SILS techniques often involve specialized ports or sutures for organ manipulation, which can add complexity or cost.

Purpose of the Study:

• To evaluate the feasibility and efficacy of using a Karl Storz 27290F grasper directly, without a trocar, for gallbladder retraction during SILS.
• To assess the safety, operative time, and cosmetic results of this trocar-less grasper technique in SILS.

Main Methods:

• A novel technique for SILS was employed in five patients, utilizing a specific grasper introduced directly through the abdominal wall.
• The grasper was used for direct gallbladder mobilization, avoiding trocar insertion for this specific maneuver.
• Intraoperative and postoperative outcomes, including complications, operative time, and scar formation, were meticulously recorded.

Main Results:

• The direct grasper technique allowed for effective gallbladder retraction and mobilization without causing gallbladder perforation or leakage.
• All five patients experienced no intraoperative or postoperative complications.
• The procedure demonstrated advantages including shorter operation times and the formation of nearly invisible postoperative skin scars.

Conclusions:

• The direct use of a grasper without a trocar for gallbladder mobilization in SILS is a safe and effective alternative.
• This technique may offer advantages over conventional suture placement for gallbladder retraction in SILS procedures.
• The method contributes to improved cosmesis and potentially reduced operative time in SILS cholecystectomy.