Three ports placed in the linea alba of the abdomen (three-midline-ports technique): An alternative approach for laparoscopic cholecystectomy

摘要

Introduction: Laparoscopic cholecystectomy is the commonest operation performed laparoscopically worldwide. In this study, we compared a three-midline-ports approach with the standard "French" method for laparoscopic cholecystectomy. Patients and Methods: A prospective, randomized study was performed between March 2010 and January 2011. One hundred consecutive patients undergoing elective cholecystectomy for symptomatic gallstones were included. The patients were randomized into two groups: those patients undergoing laparoscopic cholecystectomy following the "French" technique with three ports (Group 1) and those ones undergoing the three-midline-ports approach (Group 2). Results: Mean operation time was 70.1??19.15 minutes in Group 1 versus 65.9??17.03 minutes in Group 2 (not significant). Complications appeared in 1 patient (2%) in each group (not significant). There was no mortality. Median hospital stay was 1.5 days in both groups. Median postoperative pain evaluated by visual analog scale was 4 (range, 1-7) in Group 1 and 2.5 (range, 0-4) in Group 2 (P=.002). In both groups, the most painful port was the subumbilical one, followed by the 10-mm port and then the 5-mm one. The visual analog scale evaluation separately of the 10-mm port was 2.5 in Group 1 versus 1.5 in Group 2 (P=0.04). Conclusions: The three-midline-ports approach is a feasible technique, safe and easy to implement, associating lower postoperative pain than the standard "French" approach. ? Mary Ann Liebert, Inc.