Single-incision laparoscopic cholecystectomy with needlescope via an another port
Nobumi Tagaya, Asami Suzuki, Yoshitake Sugamata and Masatoshi Oya
World journal of Minimal Access Surgery 2012, 1:2
In single-incision laparoscopic cholecystectomy (SILC), the additional needlescopic instrument has often been inserted in the right subcostal region to improve the transumbilical manipulability between the laparoscope and surgical instruments. We applied a 3.3-mm needlescope with a zoom function via the additional port to obtain further improvement of SILC.
Patients and Methods
Between August 2009 and July 2012, 30 patients with gallbladder stones were performed SILC with a needlescope. There were 10 males and 20 females, with a mean age of 52 years. Under general anesthesia, a 2.5-cm transumbilical skin incision was made. A lap-protector was applied and covered with a glove. Two 5-mm ports and one 2-mm needlescopic instrument were inserted into the peritoneal cavity through the glove. A 3.3-mm needlescope was inserted through the right subcostal needle port. After obtaining the critical view, the cystic artery was divided using laparoscopic coagulating shears and the cystic duct was also divided after clipping. The gallbladder was freed from the liver bed and retrieved through the umbilicus.
All procedures were performed without adding another ports or conversion to open approach. The mean operation time was 78 min. There were no major intra- or postoperative complications. The 3.3-mm needlescope yielded higher quality image than the one used previously, and its zoom function allowed accurate observation. Clashing between the laparoscope and the 5-mm instruments was reduced by changing the insertion site of needlescope.
Our procedure is feasible and safe for performing SILC, and the improved results are attributable to the introduction of a 3.3-mm needlescope through the right subcostal port.