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[Video-laparoscopic cholecystectomy with suprapubic approach. Technical note]

G Degano¹, E Santarelli, E Ceraudo

¹Divisione di Chirurgia Generale, Ospedale Civile, Jesi, Ancona.

Minerva Chirurgica

|December 1, 1995

Summary

This study presents a novel videolaparoscopic cholecystectomy technique using a suprapubic incision and three trocars. The method demonstrated safety and efficacy in 29 procedures, with minimal conversions and no complications.

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Area of Science:

Minimally Invasive Surgery
Surgical Techniques
Gastrointestinal Surgery

Context:

Laparoscopic cholecystectomy is a common surgical procedure.
Standard laparoscopic cholecystectomy typically involves four trocars and umbilical incisions.
Alternative approaches are explored to improve cosmesis and reduce instrument interference.

Purpose:

To describe a personal variant of videolaparoscopic cholecystectomy.
To evaluate the safety and efficacy of a suprapubic access technique with three trocars.
To assess the aesthetic and technical advantages of this modified approach.

Summary:

A modified videolaparoscopic cholecystectomy technique is presented, utilizing a suprapubic incision for initial access and pneumoperitoneum, followed by the use of only three operating trocars.

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Twenty-nine procedures were performed with this technique, resulting in only two conversions to open surgery (unrelated to the technique) and no observed complications.

The authors also reported on 99 standard laparoscopic cholecystectomies performed concurrently, noting four reconversions and one complication (choleperitoneum).

Cases with concomitant choledochal lithiasis were managed with pre-operative ERCP, with a small number requiring laparotomy due to non-cannulatable papilla during ERCP.

Impact:

The suprapubic access offers potential aesthetic benefits and reduced instrument-camera interference.
The use of three trocars aims for cost-effectiveness and improved surgical field ergonomics.
This technique provides a safe and effective alternative for laparoscopic cholecystectomy, particularly for patients concerned with cosmetic outcomes.