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Volume 7, Issue 7 (Suppl) J Gastrointest Dig Syst
ISSN: 2161-069X JGDS, an open access journal Gastroenterologists 2017
December 14-15, 2017
Page 32
Notes:
conferenceseries.com
December 14-15, 2017 Dubai, UAE
11th World
Gastroenterologists Summit
Single incision trans-umbilical laparoscopic cholecystectomy using conventional laparoscopic
instruments: An experience of 500 cases
C holecystectomy is considered the gold standard surgery for cases of cholelithiasis. Since the first successful laparoscopic
cholecystectomy was performed in 1987, there has been a trend toward minimizing the required number and size of ports
from four to three and finally a single port to reduce abdominal wall trauma, postoperative pain and yield better cosmetic
results. We report our experiences from study of 500 cases of single incision laparoscopic cholecystectomy by transfacial
technique using conventional instruments. The study was undertaken at a tertiary care hospital over three years of 500 patients
of USG proven cholelithiasis in a single surgery unit by a single operator. The study included all cases above 14 years, male to
female ratio of patients in was 1:10 and exclusion criterion was same as for conventional cholecystectomy. The procedure was
performed using a trans-umbilical incision of size 2-2.5 cms with two 5 mm subfacial stabs for working ports and one 10 mm
stab for camera. An anterior axillary line minigrasper was used when required. The mean operative time was 30 min (range: 22-
45 min). Four of the cases were subjected to open cholecystectomy as Calot’s triangle was frozen. There was cystic artery bleed
in three cases which was taken care of using harmonic. There was slipping of clip in post-operative period in two cases which
was managed by ERCP stenting. 435 patients discharged on the 1st postoperative day and 65 patients (13.33%) discharged on
the 2nd postoperative day. The average wound length measured on 3rd postoperative day in follow up was 2 cm (range: 1.3-2.1
mm); while average score of patient satisfaction of the surgery was of 9.32 (range: 7-10). We concluded that in uncomplicated
gall bladder disease, single incision laparoscopic cholecystectomy is feasible and safe with excellent cosmetic results and high
grade of patient satisfaction and can be performed with the conventional laparoscopic instruments with adequate experience.
Biography
Lakshman Agarwal is a Senior Professor and ex-Head of Department of Surgery in SMS Medical College and Hospital, India. He holds an MBBS and MS from SMS
Medical College, Jaipur. He has more than 25 years of surgical experience in gastrointestinal surgeries. He specializes in advanced laparoscopic procedures with
13+ years of experience, consulting 100+ cases and operating 50+ cases per week pertaining to GI related problems.
Lakshman Agarwal
SMS Medical College and Hospital, India
Lakshman Agarwal, J Gastrointest Dig Syst 2017, 7:7 (Suppl)
DOI: 10.4172/2161-069X-C1-060