[Transumbilical cholecystectomy using hybrid technique: a new promising approach]

Area of Science:

• Minimally Invasive Surgery
• Laparoscopic Cholecystectomy
• Surgical Innovation

Context:

• Transumbilical cholecystectomy (TUC) offers cosmetic benefits but can present triangulation challenges.
• Existing magnetic TUC techniques risk instrument collision, complicating the procedure, especially in pediatric patients.
• A simplified hybrid approach is needed to enhance safety and efficiency in TUC.

Purpose:

• To introduce and evaluate a novel hybrid technique for transumbilical cholecystectomy using a single magnet and a curved grasper.
• To assess the feasibility, safety, and effectiveness of this simplified approach in achieving optimal surgical views and outcomes.
• To overcome the limitations of previous magnetic TUC methods, particularly instrument collision.

Summary:

• A retrospective review of 26 patients undergoing TUC with the hybrid technique was conducted.
• The technique involves using a laparoscope with a working channel for magnet insertion and a flexible trocar for a curved grasper.
• All cases achieved the critical view of safety without instrument collision, demonstrating a mean operative time of 62 minutes.

Impact:

• The hybrid technique simplifies transumbilical surgery, enhancing safety and reproducibility.
• It effectively achieves the critical view of safety, crucial for preventing bile duct injury.
• This method presents a feasible and safe alternative for pediatric and adult transumbilical cholecystectomy.