Two-Incision Laparoscopic Cholecystectomy: Reducing Scars in a Simple Way

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Cholelithiasis affects 20% of the population, being a leading cause of abdominal hospitalization.
• Over 700,000 cholecystectomies are performed annually in the US, highlighting the public health significance.
• Conventional laparoscopic cholecystectomy (LC) is the standard surgical approach.

Purpose of the Study:

• To evaluate the feasibility, safety, and aesthetic outcomes of a novel two-incision laparoscopic cholecystectomy (TILC) technique.
• To compare TILC with conventional LC using standard surgical instruments.
• To determine if TILC impacts operative time or complication rates.

Main Methods:

• A prospective case series of 36 patients undergoing TILC was compared to a historical cohort of 36 patients who had undergone LC.
• TILC utilized three trocars placed in two incisions: two in the umbilical region and one in the epigastrium.
• Surgical difficulty was classified, and outcomes including operative time and complications were recorded.

Main Results:

• No significant differences were observed in patient demographics or length of hospital stay between TILC and LC groups.
• Mean operative time for TILC was 40 minutes, compared to 49 minutes for LC, with no statistically significant difference.
• Minor complications occurred in 6.94% of procedures, with no significant difference between the two techniques. No conversions to open surgery were required.

Conclusions:

• Two-incision laparoscopic cholecystectomy (TILC) is a feasible and safe surgical option for gallbladder removal.
• TILC provides comparable safety and efficacy to conventional LC, with the added benefit of potentially improved aesthetic results.
• The technique utilizes standard laparoscopic instruments and does not prolong operative time.