Laparoscopic transumbilical cholecystectomy. Results with the gel device and literature review

• Published in: Cirugia Española Vol. 87; no. 5; p. 293
• Main Authors: Garijo Alvarez, Jesús, Sánchez López, José Daniel, González Elosua, Tomás, Gascón Hove, Martín, García-Sancho Téllez, Luis, Del Castillo Diez, Federico, Torres Jiménez, Jesús
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-05-2010
• Subjects: Cholecystectomy, Laparoscopic - methods; Cholelithiasis - surgery; Gels; Humans; Umbilical Cord - surgery
• ISSN: 1578-147X
• DOI: 10.1016/j.ciresp.2010.02.003

The appearance of single transumbilical incision surgery has opened a new era in the minimally invasive approach of cholecystectomy. Specific ports for this technique have made it easier to perform. We report our initial experience, from July 2008 to June 2009 and give an updated bibliographic review.
A prospective, longitudinal and interventional study that included 30 patients with symptomatic cholelithiasis, from 10 July 2008 to 30 June 2009, on whom a single transumbilical incision laparoscopic cholecystectomy was performed (LESS technique), without other minilaparoscopic ports or traction stitches. A gel port was used for all surgeries (R-Port, Tri-Port), as well as straight and roticulating laparoscopic graspers. Surgical time, analgesia requirements, postoperative hospital stay, conversions and complications were registered.
The median age was 34.8 years (range, from 21 to 53), with a BMI between 21 kg/m(2) and 39.5 kg/m(2) (mean 25.8 kg/m(2)). Surgical time was 65.1 minutes (ranging from 40 to 150) and postoperative length stay was less than 24 hours. Postoperative pain was measured with the VAS scale, giving a low score. Up to now, two wound infections and a bile leak have been observed.
LESS cholecystectomy is a safe and feasible technique performed by experienced surgeons in minimally invasive surgery, and requires a greater learning curve than that of the conventional laparoscopic cholecystectomy.