Cholecystectomy via a mini subcostal rectus muscle splitting incision [RMSI]

ABSTRACT

This study presented an assessment of the safety and feasibility of cholecystectomy via a 5 cm subcostal rectus muscle splitting incision [RMSI] in 50 patients with symptomatic stones confined to the gallbladder and without hepatic, pancreatic or CBD abnormalities. Their ages ranged from 25 to 60 years [mean 40 years]. Cholecystectomy was possible through the initial incision in 38 patients and with extension within the mini range [up to 8 cm] of the initial incision in 7 other patients. A total of 45 patients was successfully cholecystectomized through an incision of 5.5 cm mean length. Conversion was required in the remaining five patients. The decision to extend or to convert was prompted by adhesions and/or obscure anatomy. No CBD injury resulted, only four wound infections and one moderate atelectasis occurred. It was concluded that cholecystectomy via a mini SRMSI is a safe and feasible operation. It is followed by a short recovery time and good cosmetic appearance and can be adopted in general hospitals for all comers with stones confined to the gallbladder and for those in whom laparoscopic technique fails