Modified transumbilical laparoscopic cholecystectomy: double-incision, triple-port access

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Gastrointestinal Surgery

Background:

• Transumbilical laparoscopic cholecystectomy (TLC) offers cosmetic benefits but can be limited by instrument crowding.
• Conventional laparoscopic instruments and special access devices are used in TLC.
• A modified approach using conventional instruments and a triple-port access may overcome these limitations.

Purpose of the Study:

• To evaluate the safety and feasibility of a modified transumbilical laparoscopic cholecystectomy (TLC) technique.
• To assess the efficacy of a two-incision, triple-port access approach using conventional laparoscopic instruments for cholecystectomy.
• To compare the modified TLC technique with standard TLC regarding operative time, complications, and cosmetic outcomes.

Main Methods:

• A modified transumbilical laparoscopic cholecystectomy (TLC) technique was developed using a two-incision, triple-port access approach.
• Conventional laparoscopic instruments were utilized in all procedures.
• Fifty-two patients underwent the modified TLC, and outcomes were prospectively evaluated.

Main Results:

• All 52 procedures were completed successfully.
• Average operative time for the majority of cases was 50 ± 14 minutes.
• Patients were discharged on postoperative day 3 with no observed complications during follow-up, and reported high satisfaction with cosmetic results.

Conclusions:

• The modified transumbilical laparoscopic cholecystectomy (TLC) using a double-incision, triple-port approach with conventional instruments is safe and feasible.
• This technique reduces instrument conflict without requiring specialized devices.
• The modified TLC offers excellent cosmetic outcomes and patient satisfaction.