Triple Umbilical Incision for Videlaparoscopic Cholecystectomy| Stephy Publishers

 



Surgery International Open Access Journal - (SIOAJ) | Stephy Publishers


Abstract
Introduction: The laparoscopic surgery is done by using a single port. You place a device through a single incision between 18mm to 50mm and 3-4 trocars can be used. Our work consists of making 3 little incisions to put the three trocars which measure 5 mm and use conventional instruments that measure 36 cm of length of laparoscopic surgery within the internal limits of the umbilicus.

Objective: Describe the surgery technique and evaluate the initial results of a laparoscopic cholecystectomy option through three intraumbilical incisions.

Methods: It is a retrospective, descriptive, multicentre and observational study. Since June 2014 to August 2019, 20 patients, 17 females and 3 males, were operated using this method from the age ranges of 16 to 65 years old. The average surgical time was 65 minutes.

Results: In all cases the procedures were concluded by the intraumbilical approach. One of the cases had to be re-operated due to intraabdominal bleeding from the posterior branch of the cystic artery.

Conclusions: The technique is reproducible; the usual triangulation of the ports is not available. Therefore, fort this technique the surgeon needs to have experience and have had advanced training in laparoscopic surgery. The cases must be selective.

Keywords: Triple incision, Umbilicus and Cholecystectomy

Introduction
The laparoscopy has appeared as one of the most significant advances in XX century surgery. Since Philippe Mouret has made the first videolaparoscopic cholecystectomy in 1985, the laparoscopy has become in the approach of choice for this technique, today it is the most commonly performed laparoscopic procedure in the world.1 The evolution of the minimally techniques invasive has led to the emergency of 2 new approaches and multiples intermediates routs, on the one hand, the surgery through natural anatomical or ifice (natural orifice transluminal endoscopic surgery (NOTES),2‒5 and, for another hand, the surgery through a single incision (single incision laparoscopic surgery (SILSs) Single port, or currently called, laparoendoscopic single-site surgery (LESS), which most of the cases is the umbilicus, the embryological orifice that is repermeabilized to perform the intervention, (embryonic natural orifice transumbilical endoscopic surgery/LESS). So far, numerous procedures with multiple acronyms have been reported in the literature, however, the most acceptable seems to be LEES (From English: laparo-endoscopic single-site surgery) and whose translation into Spanish is laparoscopic surgery through a single port.


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