Acta clinica Croatica, Vol. 47 No. 4, 2008.
Ostalo
Single Incision Laparoscopic Surgery (Sils) Cholecystectomy: Where Are We?
Jakša Filipović Čugura
Josip Janković
Tomislav Kuliš
Iva Kirac
Miroslav Bekavac Bešlin
Sažetak
Laparoscopic cholecystectomy has become gold standard for cholecystectomy. The tendency of minimizing surgical trauma encourages the use of new approaches in laparoscopic surgery. Single incision laparoscopic surgery (SILS) cholecystectomy was first performed ten years ago; however, it is only recent technologic development that has enabled its wider acceptance. We report on a case of a 69 year-old female patient scheduled for elective laparoscopic cholecystectomy due to symptomatic ultrasonography verified cholelithiasis. A single 2.5-cm long semicircular supraumbilical skin incision was used. Pneumoperitoneum was established with the Veress access needle. Abdominal cavity was entered through three trocars: 10-mm trocar for camera and two 5-mm trocars, each placed 1 cm laterally and cranially from the 10-mm trocar. Antegrade cholecystectomy was performed without stay suture placement. Postoperative course was uneventful. The benefits of transition from standard laparoscopic approach to SILS will not be as obvious as was the transition from open to laparoscopic cholecystectomy. However, it cannot be overstated that every additional incision and trocar placement poses a risk of bleeding, organ damage and incisional hernia. SILS approach is feasible with standard and slightly modified instruments for standard laparoscopic cholecystectomy, thus posing minimal additional challenge to the laparoscopic surgeon. Accordingly, we believe that the use of this approach for cholecystectomy is worthwhile.
Ključne riječi
Cholecystecomy - methods, Cholecystecomy, laparoscopic - methods; Case report
Hrčak ID:
34887
URI
Datum izdavanja:
1.12.2008.
Posjeta: 1.958 *