Natural orifice transluminal endoscopic surgery (hybrid) cholecystectomy: The Dhillon technique

• Published in: Journal of minimal access surgery Vol. 13; no. 3; pp. 176 - 181
• Main Authors: Dhillon, Kanwarjit Singh, Awasthi, Divya, Dhillon, Arshbir Singh
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-07-2017; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Abdomen; Cholecystectomy; Endoscopy; Gallbladder diseases; Gastrointestinal surgery; Hospitals; Laparoscopy; natural orifice transluminal endoscopic surgery; Original; Pain; Patient outcomes; Skin; Software; Statistical analysis; Working groups
• ISSN: 0972-9941; 1998-3921
• DOI: 10.4103/0972-9941.207838

This study presents a novel technique to perform cholecystectomy and assess its outcome and feasibility.
This study presents the novel Dhillon technique and experience of hybrid natural orifice transluminal endoscopic surgery (NOTES) technique, that is, laparoscopic-assisted transvaginal cholecystectomy. We have evaluated the outcomes in terms of cosmesis, post-operative recovery and analgesic requirement. The study included 257 patients who underwent hybrid NOTES cholecystectomy at single tertiary hospital. The biographical data, surgical time, pain score on day 1 and 2, need of analgesia, intra- and post-operative complication and aesthetic assessment on day 7 were recorded.
Out of a total of 1100 cases of laparoscopic cholecystectomy 257 had hybrid NOTES cholecystectomy. Only two of these cases were converted to standard laparoscopic cholecystectomy. The mean operative time was 31.5 ± 5.1 (25-40) min. None of the patients had any complication or biliary leakage. The mean pain score on day 1 and 2 was 3.6 ± 0.4 (3-4) and 1.0 ± 0.06 (1-2), respectively. The mean paracetamol (analgesic) dose requirement was 6.1 ± 0.6 (4-6.9) g. The aesthetic score was excellent in all the cases.
Using the present technique of hybrid NOTES is beneficial in terms of cosmetic results, lesser need of analgesic and shorter hospital stay.