Double Trocar Transumbilical Endoscopic Cholecystectomy:Report of 26 Cases / 中国微创外科杂志

ABSTRACT

Objective Owing to limitations in issues of access,tissue manipulation,and secure tissue approximation/closure,natural orifice transluminal endoscopic surgery(NOTES)has been developed slowly over the years.In this study,we employed a new approach,transumbilical endoscopic surgery(TUES)to treat 26 patients with gallbladder diseases.Methods A total of 26 patients including 21 cases of gallbladder stone and 5 cases of polyps underwent TUES cholecystectomy in our hospital.Two 5-mm trocars were placed through an infra-umbilicus incision.A mini grasper was placed at the right upper abdomen to grasp the fundus of gallbladder,so that the gallbladder can be dissected and removed by using conventional laparoscopic instruments.Results The operation was completed in all the cases except in one,who was converted to conventional laparoscopic surgery because of intraoperative bleeding.The operation time was between 25 and 50 minutes with a mean of 35 minutes.No postoperative bleeding or bile leakage occurred in this group of patients.Satisfying cosmetic results were achieved on the abdomen.Conclusions Double trocar transumbilical endoscopic cholecystectomy is feasible,and is simpler and safer than NOTES technique.Patients should be carefully selected at the beginning stage.