Laparoscopic cholecystectomy via two ports, using the "Twin-Port" system

Abstract

We developed a "Twin-Port" system that allows a 5-mm camera and a forceps to be inserted through a single port for the laparoscopic cholecystectomy procedure. An infraumbilical incision of approximately 10 mm is made to insert the "Twin-Port". After pneumoperitoneum is performed, a 5-mm camera and grasper are inserted to expose the gallbladder. A 5-mm trocar is inserted approximately 1 cm below the xiphoid process, and laparoscopic cholecystectomy is performed via two ports. The gallbladder is removed through the opened "Twin-Port". The operation was performed in 40 patients without acute inflammatory gallbladder disease. None of the patients required open abdominal surgery. In 3 patients, an additional 5-mm trocar was inserted because of difficulty in removing the gallbladder from the gallbladder fossa. Mean operation time was 49 min. The size of the infraumbilical wound was almost the same as that with the conventional procedure using a 10-mm trocar. The "Twin-Port" system was devised to make laparoscopic cholecystectomy possible through two ports in the clinical setting. It may be less invasive than other LC procedures, and also has cosmetic and cost advantages. This procedure appears promising as a practical surgical treatment for cholecystolithiasis and gallbladder polyps.