Is fourth port really required in laparoscopic cholecystectomy?

Area of Science:

• General Surgery
• Minimally Invasive Surgery

Background:

• Laparoscopic cholecystectomy is a common surgical procedure.
• Modifications to the conventional four-port technique have been explored to improve outcomes and reduce invasiveness.

Purpose of the Study:

• To prospectively assess the feasibility and safety of a three-port laparoscopic cholecystectomy.
• To compare the outcomes of the three-port technique with the conventional four-port approach.

Main Methods:

• A prospective study involving fifty patients with cholelithiasis undergoing three-port cholecystectomy.
• Data collected included intra-operative and post-operative parameters.
• All procedures were performed by a single surgeon without specific patient selection criteria.

Main Results:

• All fifty procedures were completed successfully, with no conversions to open surgery or major complications.
• Three patients required the addition of a fourth port.
• Mean operative time was 55 minutes, average blood loss was 30 ml, and mean hospital stay was 1 day.
• Patients returned to routine activities within one week, with a mean follow-up of 5 months.

Conclusions:

• Three-port laparoscopic cholecystectomy is a safe and feasible alternative to the four-port technique.
• The procedure offers improved cosmetic results with fewer scars and no increased risk of bile duct injury.
• It also reduces the requirement for surgical assistants, making it an efficient alternative.