Mini-Laparoscopic Cholecystectomy: Review of 7200 Cases. Could it be the New Gold Standard?

Mini-Laparoscopy by reducing the instrument size and hence incision can lead to better surgical outcome. The safety and feasibility of mini-laparoscopic cholecystectomy (mini-Lch) has not been documented with a large patient sample. This observational descriptive study reports the results of 7200 cases of mini-Lch performed at Ibrahim General Hospital and Eden Multi-care hospital, Dhaka, Bangladesh by a single surgeon. From May 1998 till July 2013in total 8700 patients were offered Mini-lch and 7200 procedures were completed successfully. The operative indication, total operative time, conversion rate, hospital stay, patient satisfaction, post operative pain, complications, morbidity and mortality were reviewed. In this series conversion to open surgery was 0.39%. Average operating time was 30.22 minutes. Early acute cases (9%) did not require conversion to open. Average post operative hospital stay was 21 hours. There was no mortality in the series. Six patients developed incisional hernia at the umbilical port site and 16 patients had umbilical wound infection. Patient acceptance was excellent, postoperative analgesic requirement was less. With Mini Lch better cosmetic result was achieved, recovery was early. Minilaparoscopic cholecystectomy is an economically feasible, and more acceptable considering the cosmetic outcome and patient acceptance. Our results indicate that this procedure could be performed successfully and safely by experienced surgeons.