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Two Port Laparoscopic Cholecystectomy
General Surgery / Jul 7th, 2016 6:27 am     A+ | a-

Laparoscopic cholecystectomy is now Choice of surgeons in every stone of diabetes, but without increase in the minimum access surgical skill of the surgeon with new equipment. Normally, laparoscopic cholecystectomy was performed using the technique four ports or three ports. Two port laparoscopic cholecystectomy is rarely performed because it requires more knowledge and laparoscopic skills. Laparoscopic technique is cheaper and less scarring than conventional four ports laparoscopic cholecystectomy. Mini Stryker crocodile can be used as an instrument to support the anterolateral traction gallbladder.
 
The laparoscopic cholecystectomy is the gold standard for treatment of stones in the bladder. The operation is usually performed by three or four points entering the stomach. Today one incision laparoscopic cholecystectomy is the most popular, the first two port cholecystectomy was performed in 2002. Two port cholecystectomy should not SILS port articulation instruments. We have developed a special facility for this type of operation and since then it is usually performed laparoscopic cholecystectomy with two ports.
 
We have developed a new technique to perform cholecystectomy two ports with the help of extracorporeal Meltzer modified node. With this technique we can give traction on the gallbladder in all directions for proper exposure. This new innovative method of removing the gallbladder with two ports can be used for a simple case of simple stones experienced, surgeons has the advantage over conventional four-port cholecystectomy.
 
Operative Technique
 
In our two ports technique, harmonic or hook is inserted into the abdomen through trocars of 5 mm below the xiphoid process, and grips that were used as extra exposure to instruments introduced through the lower right umbilical incision for optical trocar. With the help of background withdrawal, this wizard tool can provide adequate exposure movements of smaller scale. Direct insertion of curved forceps, instruments "sword collision" can be avoided to a greater extent. Tanks mounted needle can expose the body or reject the neighbors directly or by holding the seam loops sewn into body tissues. Sew serous walls instead of the gallbladder bile can also prevent light leakage in the gallbladder during handling. In our experience, the best screen performance dissection cholecystectomy first retina was obtained by this withdrawal surgical serosa.

The presentation was even better than providing the LC-four conventional, especially if the gallbladder is too stretched or wall is too thin for the insertion port. And conducted a study on 120 patients randomized comparison four port and two-port LC. They found that the two ports LC gave less operating time, less pain-port site, similar clinical outcomes and fewer surgical scars. Although compared with the LC four or three standard ports, we believe that the focus of two ports with the assembled needle time the tank is taken stopped working due to acute and chronic cholecystitis the gallbladder wall and thickened more stones represent a large proportion of cases. In these cases, retractable seam of serous holdings provide better exposure by cutting holdings of the first, but this approach transumbilical incision made two extraction ports faster displayed.

The operation was successful in all thirty patients without conversion to open surgery in patients. The average duration of surgery was 35 ± 5 minutes SD. No complications were observed in patients during the follow-up six months after surgery. No pneumothorax in patients.
 
Patients were allowed oral feeding 6 hours after surgery and discharged from hospital after surgery. The patients were satisfied with the cosmetic results after surgery with a score of satisfaction 7 and above in all patients.
 
Discussion
 
In the new era of minimal access surgery, the better the results of the research are not only safety but also quality, which is often defined pain and cosmetic results. Scarless surgery is the ultimate goal for both surgeon and patient. minimally invasive surgical techniques continue to evolve. As technology and tools to further improve, so that the complexity of the tasks that can be performed in a minimally invasive manner.
 
Two port laparoscopic cholecystectomy showed satisfaction over the patient. However, if offers additional benefits remains controversial. A report on the two port laparoscopic cholecystectomy has already shown that all patients opting for this technique to access four ports, such as postoperative pain is significantly reduced and the process is aesthetically more acceptable to patients.
 
Two port laparoscopic cholecystectomy is reported to be safe and feasible, but it is technically difficult, even experienced hands, because of limited operative field. laparoscopic surgeons are developing and using several different techniques in the world. WT Ng described the use of laparoscopic cholecystectomy one supra-umbilical incision; However, the only wound was in fact the result of a combination of cameras and the adjacent working ports 10 mm. KW Lee reported a cholecystectomy with two ports scopic needle of 2 mm or 3 mm forceps Endo.
 
Publication show a new indication for laparoscopic cholecystectomy access to two ports, using the method of raising the abdominal wall. They noted that the withdrawal from the gallbladder is possible by inserting the forceps through the umbilical port with a telescope that can eliminate the need for third port are received. The surgeon has developed a system of "Twin-port", which allows the camera to 5 mm and a clip that is inserted through a single port. 5mm trocar is inserted approximately cm below the top of the sternum, a laparoscopic cholecystectomy performed through two ports. 30 degree conventional telescope and camera used in this study. Withdrawal from the gallbladder, either the front or rear dissection is not a problem in any of the patients, and all operations are performed promptly and safely with good patient satisfaction.

Conclusion:
 
Both port laparoscopic cholecystectomy, which is described here is a safe and simple procedure and can be performed by inexperienced surgeons in laparoscopic surgery. Patient satisfaction is very good and there is no additional risk to patients. Thus, the techniques mentioned above can be used as an alternative to laparoscopic surgery one cut in developing and developing countries, especially surgeons who work in rural areas.
 
5 COMMENTS
Dr. Sarita
#1
Apr 26th, 2020 10:33 am
Very stimulating teaching style. Thanks for posting of Two Port Laparoscopic Cholecystectomy video.
Dilara
#2
May 18th, 2020 9:15 am
This is really amazing video in which you have shown us the two port of laparoscopy cholcystectomy surgery with the help of extracorporeal Meltzer modified knot,this is very informative and help us a lot.
Dr. Michael
#3
May 22nd, 2020 2:59 pm
This video is very helpful for doctors. Thanks for sharing Two Port Laparoscopic Cholecystectomy
Dr. Naveen Dahiya
#4
Jun 12th, 2020 7:26 am
Such an excellent presentation. Excellent surgery techniques. Thanks for uploading this video of Two Port Laparoscopic Cholecystectomy
Dr. Kundan Lal Tiwari
#5
Jun 16th, 2020 6:37 pm
Literally the best explanation of Two Port Laparoscopic Cholecystectomy!! I tried learning through other lectures and through videos and couldn’t fully understand and remember the details until I watched this video thank you!. Dr. Mishra your teaching is amazing, you are an great teacher.
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