[Alternatives to minimally invasive cholecystectomy]

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Traditional cholecystectomy (laparoscopic and open) has associated risks and costs.
• Development of minimally invasive techniques aims to improve patient outcomes and reduce healthcare expenses.
• Open endoscopic approaches offer potential advantages over existing methods.

Purpose of the Study:

• To introduce and evaluate open endoscopic minimally invasive cholecystectomy (OEMIC) procedures.
• To assess the safety, efficacy, and applicability of OEMIC.
• To present OEMIC as a viable alternative to conventional and laparoscopic cholecystectomy.

Main Methods:

• Two variations of OEMIC were performed: microsurgical removal with a small incision (2-2.5 cm) and a larger incision (2.6-6 cm).
• A total of 200 consecutive OEMIC procedures were conducted between 1990 and the study period.
• Patient selection included a wide range of gallbladder conditions and previous surgical histories.

Main Results:

• 200 consecutive OEMIC procedures performed with zero mortality.
• A low morbidity rate of 1% was observed across all cases.
• The procedures were successfully applied to diverse patient groups, including those with choledocholithiasis and previous abdominal surgeries.

Conclusions:

• Open endoscopic minimally invasive cholecystectomy is a safe and effective alternative to conventional and laparoscopic gallbladder removal.
• OEMIC demonstrates a favorable safety profile with low morbidity and no mortality.
• This technique is a cost-effective option suitable for a broad spectrum of patients with gallbladder disease.