Two-Incision Laparoscopic Cholecystectomy: Reducing Scars in a Simple Way.

BACKGROUND: About 20% of the population has cholelithiasis and this is the main abdominal cause of hospitalization in developed countries. Considering that only in the United States about 700,000 cholecystectomies are done each year, it is possible to estimate the importance of the problem for public health. OBJECTIVE: To describe a two-incision laparoscopic cholecystectomy (TILC) technique using only conventional material, without increasing complications or operative time. MATERIALS AND METHODS: A consecutive and prospective case series compared to another historical operated by conventional laparoscopic cholecystectomy (LC). The TILC was performed with three trocars in two incisions, two trocars in umbilical incision, and one in epigastrium. RESULTS: A total of 72 patients were operated on by the same surgeon (36 in each group). There were no significant differences between groups for gender, mean age, body mass index, or length of hospital stay. The procedures were classified by the surgeon according to surgical difficulty and 58.3% (n = 42) were considered low grade, 9.7% (n = 7) difficult, and the other were intermediaries, with no difference between the series (P < .05). There were minor complications in 6.94% (n = 5) procedures. There were no differences between mean operative time (P = .989), which was 49 (95% confidence interval [CI] 42-56) minutes in LC and 40 (95% CI 35-44) min in TILC. There was no need for additional trocars in any case or for conversion to open surgery. CONCLUSIONS: TILC is feasible, safe, and with good aesthetic result, using the same instruments of LC, without increasing operative time.

Simplified laparoscopic cholecystectomy with two incisions / Colecistectomia videolaparoscópica simplificada com duas incisões

BACKGROUND: Laparoscopic cholecystectomy has traditionally been performed with four incisions to insert four trocars, in a simple, efficient and safe way. AIM: To describe a simplified technique of laparoscopic cholecystectomy with two incisions, using basic conventional instrumental. TECHNIQUE: In one incision in the umbilicus are applied two trocars and in epigastrium one more. The use of two trocars on the same incision, working in "x" does not hinder the procedure and does not require special instruments. CONCLUSION: Simplified laparoscopic cholecystectomy with two incisions is feasible and easy to perform, allowing to operate with ergonomy and safety, with good cosmetic result. .

INTRODUÇÃO - A colecistectomia videolaparoscópica vem tradicionalmente sendo realizada através de quatro incisões para inserção de quatro portais, de maneira simples, eficiente e segura. OBJETIVO: Descrever técnica de colecistectomia videolaparoscópica simplificada com duas incisões, utilizando instrumental convencional básico. TÉCNICA: Na incisão da cicatriz umbilical aplicam-se dois portais e no epigástrio mais um portal. O uso de dois portais na mesma incisão, trabalhando em "x", não dificulta a realização do procedimento e não requer instrumental especial. CONCLUSÃO: A colecistectomia videolaparoscópica simplificada com duas incisões é técnica de fácil execução, permitindo operar com ergonomia, segurança e com bom resultado estético. .

Simplified laparoscopic cholecystectomy with two incisions.

BACKGROUND: Laparoscopic cholecystectomy has traditionally been performed with four incisions to insert four trocars, in a simple, efficient and safe way. AIM: To describe a simplified technique of laparoscopic cholecystectomy with two incisions, using basic conventional instrumental. TECHNIQUE: In one incision in the umbilicus are applied two trocars and in epigastrium one more. The use of two trocars on the same incision, working in "x" does not hinder the procedure and does not require special instruments. CONCLUSION: Simplified laparoscopic cholecystectomy with two incisions is feasible and easy to perform, allowing to operate with ergonomy and safety, with good cosmetic result.