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Comparison of postoperative outcomes between conventional and low-impact laparoscopic cholecystectomy: a randomized
Hüseyin Şahinoğulları1, Anıl Ergin2, Ender Onur3
1Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey. huseyinsahinogullari@gmail.com.
Background:
Low-impact laparoscopy is an innovative surgical technique and aims to improve the postoperative recovery process and preserve surgical efficacy with lower insufflation pressure and minimal incisions. Our study aimed to compare the effects of low-impact laparoscopic cholecystectomy (LILC) and conventional laparoscopic cholecystectomy (CLC) on postoperative pain, early complications, hospital stay and surgery duration.
Methods:
In our study, a total of 104 patients were analyzed, 52 patients in the LILC group and 52 patients in the CLC group. In the LILC group, cholecystectomy was performed under low pressure (8 mmHg) and minimal incisions (3-5 mm). In the CLC group, cholecystectomy was performed under standard pressure (12 mmHg) and with standard incisions (5-10 mm). Pain was assessed using a visual analog scale (VAS) at 2, 4, 6, 12, 24 h after surgery. Additional analgesia requirements were recorded. Early complications as wound infection, bleeding, intra-abdominal abscess/collection were evaluated according to the Clavien-Dindo classification. The duration of surgery, length of hospital stay, and presence of nausea and vomiting were noted.
Results:
VAS scores were significantly lower in the LILC group than in the control group at 2, 4, 6, 12, 24 h.The additional analgesia requirement was significantly lower in the LILC group at 2, 4, 6, 12 h.Nausea and vomiting were not present at the 12th hour in the LILC group. The duration of surgery was significantly lower in the LILC group.No significant difference was observed between the duration of hospital stay and the complication grade according to the Clavien‒Dindo classification.
Conclusions:
LILC was evaluated as a safe and effective method for reducing postoperative pain, reducing the need for additional analgesia and shortening the duration of surgery. It is a method that can be used safely by an experienced surgeon for appropriate patient selection.
