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Laparoscopic cholecystectomy with two mini cosmetic incisions
Alireza Tavassoli1, Sajad Noorshafiee2
1Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Updates in Surgery
|December 20, 2017
Summary
Double-incision laparoscopic cholecystectomy offers a safe, cost-effective alternative to conventional methods. This minimally invasive surgery reduces pain, improves patient satisfaction, and allows for a quicker return to work compared to four-port procedures.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic cholecystectomy is a common procedure, with four-port technique being standard.
- Emerging techniques like Single-Incision Laparoscopic Surgery (SILS) aim for better cosmesis but can increase costs.
- There is a need for minimally invasive techniques that balance cosmetic benefits with cost-effectiveness and surgical quality.
Purpose of the Study:
- To evaluate a novel double-incision laparoscopic cholecystectomy (DILS) technique.
- To compare DILS with conventional four-port laparoscopic cholecystectomy (CLS) regarding cosmetic outcomes, quality, and cost.
- To assess patient-reported outcomes including pain, satisfaction, and return to work.
Main Methods:
- A double-blind clinical trial conducted from December 2012 to September 2014.
- Patients undergoing cholecystectomy were randomized into two groups: DILS and CLS.
- Demographic data, operative time, pain scores, patient satisfaction, and return to work were recorded and compared.
Main Results:
- No statistically significant differences in mean age or BMI between groups.
- Mean operation time was slightly longer (approx. 2 minutes) in the DILS group, considered clinically insignificant.
- The DILS group reported significantly lower pain scores (p < 0.0001), higher patient satisfaction, and an earlier return to work (p < 0.0001).
Conclusions:
- Double-incision laparoscopic cholecystectomy (DILS) is a safe and effective alternative for uncomplicated cholelithiasis.
- Reducing port number in DILS leads to decreased pain, reduced analgesic requirements, shorter hospital stays, and faster return to work.
- DILS, utilizing conventional instruments, presents a cost-effective option potentially superior to SILS in terms of overall patient benefit and hospital charges.
