Suprapubic laparoscopic cholecystectomy: technique and preliminary results

Area of Science:

• Minimally invasive surgery
• Laparoscopic surgery
• Surgical innovation

Background:

• Minimally invasive abdominal surgery has advanced, yet single-incision and natural orifice techniques remain costly and have variable aesthetic outcomes.
• Existing minimally invasive methods present challenges in implementation and patient satisfaction regarding cosmetic results.

Purpose of the Study:

• To standardize and evaluate a novel laparoscopic suprapubic access technique for cholecystectomy, termed Supra Pubic Endoscopic Surgery (SPES).
• To present the preliminary outcomes of SPES, focusing on feasibility, safety, and cosmetic benefits.

Main Methods:

• A prospective study evaluating 30 patients undergoing SPES for cholecystectomy between March and June 2012.
• The SPES technique involved three incisions: umbilical for instrumentation, right groin for manipulation, and suprapubic for camera access.
• Standard laparoscopic procedures were employed, including dissection, clipping, and retrograde gallbladder resection, with intraoperative cholangiography performed as indicated.

Main Results:

• Thirty patients (mean age 40.7 years) underwent SPES for various gallbladder conditions, including biliary colic (60%), cholecystitis (16.6%), and others.
• The average body mass index was 27.8, with operative times ranging from 24 to 70 minutes.
• No significant postoperative complications were reported in the evaluated cohort.

Conclusions:

• Supra Pubic Endoscopic Surgery (SPES) is a feasible and safe laparoscopic technique for cholecystectomy.
• The procedure demonstrated satisfactory cosmetic results, addressing a key limitation of some current minimally invasive approaches.
• SPES offers a promising alternative for gallbladder surgery with good patient outcomes.