Laparoscopic cholecystectomy: modifications of the technique

ABSTRACT

Laparoscopic cholecystectomy has been rapidly replacing the traditional method of open cholecystectomy. With experience of the technique surgeons are adding and developing technical "tips" and modifying the procedure for better safety and convenience of the patients. This work presented the patients in whom minor modifications of the technique in special situations is made. Three parts only for easy cholecystectomy in 20 patients are used. The second modification is aspiration and retraction of the gallbladder while keeping the Veress needle inside the gallbladder dissection for acute cholecystitis in 10 patients. Modification of umbilical port closure is by the use of Vicryl stay sutures in 10 patients or the use of prolene plug in 10 patients. Laparoscopic cholecystectomy with modifications of the technique was attempted in 54 patients with symptomatic gallbladder disease during the period from January 1992 to January 1994. There was no mortality. The mean operative time was 105 minutes [60-150 minutes]. In 4 patients laparoscopic cholecystectomy was converted to open cholecystectomy. The average hospital stay was 3.6 days [2-8 days] and the mean time taken for return to normal activity was 12 days [7-35 days]