Your browser doesn't support javascript.
loading
Colecistectomía laparoscópica por puerto umbilical asistido / Transumbilical laparoscopic cholecystectomy assisted with a second port: experience in 60 patients
Solano V., Nicolás; Solano R., Nicolás.
  • Solano V., Nicolás; Clínica Los Leones. La Calera. CL
  • Solano R., Nicolás; Universidad de Valparaíso. Valparaíso. CL
Rev. chil. cir ; 64(2): 147-154, abr. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-627091
ABSTRACT

Background:

Transumbilical laparoscopic surgery offers substantial esthetic benefits. The use of a second port to introduce a second trocar, reduces the need of special or articulated instruments.

Aim:

To report the experience with transumbilical cholecystectomy, assisted using a second port, to reduce technical complexity. Patients and

Methods:

The surgical technique was prospectively evaluated in 60 patients aged 18 to 77 years (39 women), that required a cholecystectomy. All had a surgical risk classified according to the American Society of Anesthesiologists (ASA) as I or II. Patients with gallbladder cancer, choledocholithiasis, were excluded. Two trocar (10 and 5 mm) were introduced by transumbilical incision and other one 5 mm trocar was introduced in the right iliac fossa for 0° frontal optics.

Results:

The mean operative time was 72 minutes (range 35-165). Fifty seven patients had a 24 h hospital stay. Two patients had to be converted to open surgery due to a complex pedicle dissection and one patient required an additional trocar. There were three complications. An umbilical seroma, a bile leakage through a Luschka duct, that was managed conservatively and one bile tract stenosis, that appeared four months after the operation and required surgical repair.

Conclusions:

Transumbilical cholecystectomy using a second additional port was a successful procedure, with similar esthetic results as single port surgery, but less costly.
RESUMEN

Introducción:

La cirugía laparoscópica evoluciona hacia técnicas menos invasivas, entre ellas la cirugía por puerto único umbilical, con mayor beneficio estético. El objetivo del presente trabajo es presentar los resultados de una técnica en colecistectomías laparoscópicas por puerto umbilical asistido por segundo puerto. La hipótesis planteada es que la técnica descrita es sencilla, segura y con beneficio estético similar al puerto único umbilical. Pacientes y

Métodos:

Técnica quirúrgica realizada prospectivamente en una serie de 60 pacientes ASA I y ASA II con consentimiento informado. Se incluye colecistolitiasis, pólipos, colecistitis aguda y crónica. Se excluye cáncer vesicular y coledocolitiasis. No se excluyeron casos por complejidad técnica o IMC. Se insertan 2 trocares de trabajo de 10 y 5 mm por incisión transumbilical y trocar de 5 mm en fosa iliaca derecha para óptica frontal de 0°.

Resultados:

Tiempo operatorio promedio de 72 minutos, mediana de 60 y extremos de 35 y 165. Tuvieron hospitalización de 24 horas 57 pacientes (95 por ciento). Hubo 2 conversiones a cirugía abierta por difícil disección del pedículo y un caso requirió trocar adicional. Hubo 3 complicaciones un seroma de ombligo, una bilirragia por conducto de Luschka manejado conservadoramente y 1 estenosis de vía biliar postoperatoria a 4 meses, con reparación quirúrgica.

Conclusiones:

La colecistectomía lapa-roscópica por puerto umbilical asistida, logra resultados exitosos y con similares ventajas estéticas que el puerto único. El bajo costo de nuestra técnica permite realizarla en hospitales públicos y centros privados con menores recursos.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Umbilicus / Cholecystectomy, Laparoscopic / Gallbladder Diseases Type of study: Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male Language: Spanish Journal: Rev. chil. cir Journal subject: General Surgery Year: 2012 Type: Article Affiliation country: Chile Institution/Affiliation country: Clínica Los Leones/CL / Universidad de Valparaíso/CL

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Index: LILACS (Americas) Main subject: Umbilicus / Cholecystectomy, Laparoscopic / Gallbladder Diseases Type of study: Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male Language: Spanish Journal: Rev. chil. cir Journal subject: General Surgery Year: 2012 Type: Article Affiliation country: Chile Institution/Affiliation country: Clínica Los Leones/CL / Universidad de Valparaíso/CL