Feasibility of laparoscopic cholecystectomy with miniaturized instrumentation in 50 consecutive cases

A new technique utilizing miniaturized (2 mm) instrumentation to perform la paroscopic cholecystectomy (LC) is introduced. The safety and efficacy of t his mini-LC were assessed Fifty consecutive mini-LCs were performed using o ne 10-mm port and three 2-mm ports (cumulative port size 16 mm), A 2-mm fib eroptic video-laparoscope was placed in the mid-epigastrium through a 2-mm port. A 10-mm umbilical port was then placed under direct visualization, al lowing access for standard laparoscopic instruments. Two additional 2 min p orts were placed in the right upper quadrant allowing insertion of grasping instruments. Parameters reviewed included total operative time (OT), posto perative length of stay (LOS). anatomic pathology complications, and rate o f conversion to conventional it and open cholecystectomy. Results were comp ared to those of 50 consecutive conventional LCs using two 10-mm and two 5- mm ports (cumulative port size 30 mm. The OT for the mini-LC and convention al LC were 88 +/- 5.9 and 78 +/- 5 minutes (mean +/- SD), respectively, (p = NS), and postoperative LOS for the mini-LC and conventional it were 1.5 /- 0.2 and 1.8 +/- 0.1 days (mean +/- SD), respectively, (p = NS). Of the 5 0 mini-LC cases, 5 required conversion to conventional it. One cystic duct leak was detected and successfully treated conservatively; no common bile d uct injuries occurred; and no patients required conversion to open cholecys tectomy. This study demonstrates the safety and efficacy of minilaparoscopi c instruments for the performance of cholecystectomy. The data reveal that this new technique is comparable to conventional LC.