Microlaparoscopic vs conventional laparoscopic cholecystectomy
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- Bisgaard, T., Klarskov, B., Trap, R. et al. Surg Endosc (2002) 16: 458. doi:10.1007/s00464-001-9026-5
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Background: Downsizing the port incisions may reduce pain after laparoscopic cholecystectomy. Methods: In a double-blind controlled study, 60 patients were randomized to undergo either microlaparoscopic cholecystectomy using one 10-mm and three 3.5-mm trocars (3.5-mm LC) or traditional laparoscopic cholecystectomy using two 10-mm and two 5-mm trocars (LC). Incisional pain at each port incision and overall pain were recorded for 1 week after the operation. Fatigue, nausea and vomiting, pulmonary function, and cosmetic results were also measured. Results: Data from 52 patients were analyzed; eight patients were excluded from the study for various reasons. One patient was converted from 3.5-mm LC to LC due to technical problems with the 3.5-mm optic. In the 3.5-mm LC group (n = 25), incisional pain was significantly decreased in the 1st postoperative week as compared with the LC group (n = 27) (p <0.01). In both groups, pain scores at the supraumbilical 10-mm port were significantly higher compared with other port sites (p <0.05). The cosmetic results were significantly better in the 3.5-mm LC group (p <0.01). There were no significant differences in any of the other variables. Conclusion: The use of 3.5-mm trocars is feasible in LC, and it both reduces incisional pain and improves the cosmetic result.