Mini-laparoscopic cholecystectomy: validating a new approach.

Overview

Advances in instrumentation have led to the development of 2-mm laparoscopic equipment. The purpose of our investigation was to validate the safety and efficacy of laparoscopic cholecystectomy (LC) using one 10-mm and three 2-mm ports (mini-LC). Mini-LC was performed using a 2-mm fiberoptic videolaparoscope inserted via a midepigastric port, 2-mm graspers inserted via right upper quadrant ports, and standard dissection, clipping, and cautery instruments inserted via the umbilical port. Data from 100 sequential patients were acquired between July 1996 and August 1997 and compared with those of 100 sequential patients who had undergone conventional LC (C-LC). The operative time ranged from 30 to 256 minutes for the mini-LC group and 25 to 255 minutes for the C-LC group, with means of 89 and 82 minutes, respectively (P > 0.05). Postoperative length of stay ranged from 0 to 18 days for the mini-LC group and 0 to 21 days for the C-LC group, with means of 1.5 and 1.9 days, respectively (P > 0.05). There were no conversions to open cholecystectomy. These data suggest that a more minimalist approach to laparoscopic cholecystectomy can be accomplished safely and effectively.