Mini-laparoscopic cholecystectomy: Validating a new approach

Advances in instrumentation have led to the development of 2-mm laparoscopi c equipment. The purpose of our investigation was to validate the safety an d efficacy of laparoscopic cholecystectomy (LC) using one 10-mm and three 2 -mm ports (mini-LC). Mini-LC was performed using a 2-mm fiberoptic videolap aroscope inserted via a midepigastric port, 2-mm graspers inserted via righ t upper quadrant ports, and standard dissection, clipping, and cautery inst ruments inserted via the umbilical port. Data from 100 sequential patients were acquired between July 1996 and August 1997 and compared with those of 100 sequential patients who had undergone conventional LC (C-LC). The opera tive time ranged from 30 to 256 minutes for the mini-LC group and 25 to 255 minutes for the C-LC group, with means of 89 and 82 minutes, respectively (P > 0.05). Postoperative length of stay ranged from 0 to 18 days for the m ini-LC group and 0 to 21 days for the C-LC group, with means of 1.5 and 1.9 days, respectively (P > 0.05). There were no conversions to open cholecyst ectomy. These data suggest that a more minimalist approach to laparoscopic cholecystectomy can be accomplished safely and effectively.