Skip to main content
Log in

Design, Development, and Evaluation of a Novel Retraction Device for Gallbladder Extraction During Laparoscopic Cholecystectomy

  • 2013 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

A source of frustration during laparoscopic cholecystectomy involves extraction of the gallbladder through port sites smaller than the gallbladder itself. We describe the development and testing of a novel device for the safe, minimal enlargement of laparoscopic port sites to extract large, stone-filled gallbladders from the abdomen.

Methods

The study device consists of a handle with a retraction tongue to shield the specimen and a guide for a scalpel to incise the fascia within the incision. Patients enrolled underwent laparoscopic cholecystectomy. Gallbladder extraction was attempted. If standard measures failed, the device was implemented. Extraction time and device utility scores were recorded for each patient. Patients returned 3–4 weeks postoperatively for assessment of pain level, cosmetic effect, and presence of infectious complications.

Results

Twenty (51 %) of 39 patients required the device. Average extraction time for the first eight patients was 120 s. After interim analysis, an improved device was used in 12 patients and average extraction time was 24 s. There were no adverse events. Postoperative pain ratings and incision cosmesis were comparable between patients with and without use of the device.

Conclusion

The study device enables safe and rapid extraction of impacted gallbladders through the abdominal wall.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Olsen DO. Laparoscopic cholecystectomy. The American Journal of Surgery. 1991;161(3):339–344. doi: 10.1016/0002-9610(91)90592-2.

    Article  CAS  Google Scholar 

  2. Dreznik Z, Soper NJ. Trocar site abscess due to spilled gallstones: An unusual late complication of laparoscopic cholecystectomy. Surg Laparosc Endosc. 1993;3(3):223–224.

    CAS  PubMed  Google Scholar 

  3. Battaglia DM, Fornasier VL, Mamazza J. Gallstone in abdominal wall—a complication of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2001;11(1):50–52.

    CAS  PubMed  Google Scholar 

  4. Zulfikaroglu B, Ozalp N, Mahir Ozmen M, Koc M. What happens to the lost gallstone during laparoscopic cholecystectomy? Surg Endosc. 2003;17(1):158. doi: 10.1007/s00464-002-4242-1.

    CAS  PubMed  Google Scholar 

  5. Sarli L, Contini S, Sansebastiano G, Gobbi S, Costi R, Roncoroni L. Does laparoscopic cholecystectomy worsen the prognosis of unsuspected gallbladder cancer? Arch Surg. 2000;135(11):1340–1344.

    Article  CAS  PubMed  Google Scholar 

  6. Wullstein C, Woeste G, Barkhausen S, Gross E, Hopt UT. Do complications related to laparoscopic cholecystectomy influence the prognosis of gallbladder cancer? Surg Endosc. 2002;16(5):828–832. doi: 10.1007/s00464-001-9085-7.

    Article  CAS  PubMed  Google Scholar 

  7. Kim JH, Kim WH, Kim JH, Yoo BM, Kim MW. Unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy: Focus on acute cholecystitis. World J Surg. 2010;34(1):114–120. doi: 10.1007/s00268-009-0279-9; 10.1007/s00268-009-0279-9.

    Google Scholar 

  8. Bordelon BM, Hobday KA, Hunter JG. Incision extension is the optimal method of difficult gallbladder extraction at laparoscopic cholecystectomy. Surg Endosc. 1992;6(5):225–227.

    Article  CAS  PubMed  Google Scholar 

  9. Sackier JM, Hunter JG, Paz-Partlow M, Cuschieri A. The rotary gallstone lithotrite to aid gallbladder extraction in laparoscopic cholecystectomy. Surg Endosc. 1992;6(5):235–238.

    Article  CAS  PubMed  Google Scholar 

  10. Bickel A, Szabo A, Shtamler B. A safe simple method for removal of the gallbladder through the umbilical trocar site during laparoscopic cholecystectomy. J Laparoendosc Surg. 1993;3(5):485–487.

    Article  CAS  PubMed  Google Scholar 

  11. Kanehira E, Omura K, Kawai K, Ishikawa N, Watanabe Y. A new extraction bag to facilitate stone extraction in laparoscopic cholecystectomy: In vitro experiments. Endosc Surg Allied Technol. 1994;2(6):297–299.

    CAS  PubMed  Google Scholar 

  12. John Hunter ST. Laparoscopic cholecystectomy, intraoperative cholangiography, and common bile duct exploration. In: Josef Fisher KB, ed. Mastery of surgery. 5th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2006:1116–1128.

Download references

Funding

This work was supported by a grant from the Biomedical Innovation Fund of the Ivy Foundation of the University of Virginia.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peter T. Hallowell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Judge, J.M., Stukenborg, G.J., Johnston, W.F. et al. Design, Development, and Evaluation of a Novel Retraction Device for Gallbladder Extraction During Laparoscopic Cholecystectomy. J Gastrointest Surg 18, 334–339 (2014). https://doi.org/10.1007/s11605-013-2292-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-013-2292-4

Keywords

Navigation