Three Port Versus Four Port Laparoscopic Cholecystectomy : A Comparative Study

Aims & Objectives: To compare three port–laparoscopic cholecystectomy (3 LC) with four port–laparoscopic cholecystectomy in term of safety, efficacy, post–op pain, hospital stay and complication rates. Material & Methods: The present study was conducted in the department of Surgery, S.N. Medical College, Agra (U.P.). Total 104 adult patients of cholelithiasis with chronic cholecystitis were included in the study. These 104 patients were randomly divided into two group (I & II) consisting of 52 patients in each group. Study was conducted for a period of 1 year from Jan. 2017 to Jan. 2018. Group–I: performed 3 port LC (3 port–laparoscopic cholecystectomy) Group–II: performed 4 port LC (4 port–laparoscopic cholecystectomy). The present study is being conducted to compare the various merits and demerits of 3 port LC and 4 port LC performed by same surgical team in the same scenario in our setup in our medical college. Results: Statistically significant different was found between the two group in term of visual analogue score for pain at 6 and 24 hr, analgesic requirement, duration of hospital stay and back to work and cosmetic outcome all being less in the three port LC group. Result of other variable were comparable in the two groups. Conclusion: Three port laparoscopic cholecystectomy resulted in less port site pain and better cosmetic outcome require fewer analgesic, fewer surgical scar and without increase in complication with shorter duration of hospital stay.

The comparison of laparoscopic-assisted vaginal hysterectomy by the number of ports / 대한산부인과내시경학회지

OBJECTIVE: To compare clinical features and surgical outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) by the number of ports in the treatment of uterine myoma and adenomyosis. METHODS: Between 1st January 2009 and 31th March 2010, 50 patients underwent 5 mm-2 port LAVH and 10 mm-3 port LAVH respectively by same surgeon at Chosun university hospital. We compared clinical features and surgical outcomes. RESULTS: There was no difference in weight of uterus between the 5 mm-2 port LAVH group and the 10 mm-3 port LAVH group (465.2+/-206.9 g vs. 470.8+/-148.5 g) (Mean+/-S.D.), and in amounts of blood loss during procedure between the two groups (115.0+/-179.3 mL vs. 125.0+/-211.7 mL). The duration of procedure showed a difference between the two groups(55.1+/-12.0 minutes vs. 60.4+/-19.5 minutes) (p=0.03). In the 5 mm-2 port LAVH group, 2 of 50 (4%) converted to laparotomy, and 1 of 50 (2%) in the 10 mm-3 port LAVH group. There was no difference in length of postoperative hospital day between the two groups (5.8+/-1.0 days vs. 6.3+/-1.6 days). In the comparison of postoperative complications, 1 of 50 (2%) required readmission and reoperation for both of the two groups. CONCLUSION: We conclude that 5 mm-2 port LAVH could be a available method in the treatment of uterine myoma and adenomyosis.

A Prospective Comparison Study of the Two-port and Three Port Techniques for Performing Laparoscopic Cholecystectomy / 대한내시경복강경외과학회지

PURPOSE: Various methods have evolved for laparoscopic cholecystectomy: the four-port, three-port or two-port methods. Some authors have recently recommended 2 port laparoscopic cholecystectomy as a useful method. We compared the clinical characteristics of the two-port method and the three-port method, and we estimated the usefulness of each method. METHODS: We performed a prospective analysis of 40 patients who underwent laparoscopic cholecystectomy by a single surgeon from September 2008 to January 2009. The two port and 3 port techniques were alternatively done during the study period by one surgeon who had adequate experience with laparoscopic surgery at Wonkwang university hospital. We compared the two groups according to the parameters of the operation time, the intraoperative complications, the conversion rate, the postoperative complications, the postoperative hospital stay, the pain at the trocar sites and the patients' satisfaction. RESULTS: There were significant differences between the two and three port groups in terms of the mean operation time, the conversion rate and the intraoperative events. The mean operation time (2 port; 38.95+/-10 min., 3 port; 23.25+/-5 min.: p<0.01), conversion rate (2 port; 5 cases, 3 port; 0 case: p=0.016) and there were fewer intraoperative events using the three port technique that that of the two port technique (2 port; 14 events, 3 port; 2 events: p<0.01). There were no significant differences of the trocar site pain, the hospital stay and the patients' satisfaction. CONCLUSION: Considering our results, the tree port technique could be regarded as the optimal surgical technique compared to the 2 port technique for performing laparoscopic cholecystectomy, or at least until new instruments for gall bladder traction and new port were not developed.