Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial.
BACKGROUND
Downsizing the port incisions may reduce pain after laparoscopic cholecystectomy.


METHODS
In a double-blind controlled study, 60 patients were randomized to undergo either microlaparoscopic cholecystectomy using one 10-mm and three 3.5-mm trocars (3.5-mm LC) or traditional laparoscopic cholecystectomy using two 10-mm and two 5-mm trocars (LC). Incisional pain at each port incision and overall pain were recorded for 1 week after the operation. Fatigue, nausea and vomiting, pulmonary function, and cosmetic results were also measured.


RESULTS
Data from 52 patients were analyzed; eight patients were excluded from the study for various reasons. One patient was converted from 3.5-mm LC to LC due to technical problems with the 3.5-mm optic. In the 3.5-mm LC group (n = 25), incisional pain was significantly decreased in the 1st postoperative week as compared with the LC group (n = 27) (p <0.01). In both groups, pain scores at the supraumbilical 10-mm port were significantly higher compared with other port sites (p <0.05). The cosmetic results were significantly better in the 3.5-mm LC group (p <0.01). There were no significant differences in any of the other variables.


CONCLUSIONS
The use of 3.5-mm trocars is feasible in LC, and it both reduces incisional pain and improves the cosmetic result.
Bisgaard
T
T
Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, 2650 Hvidovre, Denmark. bisgaard@dadlnet.dk
Klarskov
B
B
Trap
R
R
Kehlet
H
H
Rosenberg
J
J
D000758:Anesthesia / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods*; D004311:Double-Blind Method; D005240:Feasibility Studies; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D018579:Patient Selection; D011446:Prospective Studies