A new technique for two-trocar laparoscopic cholecystectomy.
BACKGROUND
New techniques for laparoscopic cholecystectomy (LC) that reduce the number of trocars or use very thin instruments have been devised with the goal of further minimizing surgical invasiveness.


METHODS
We performed two-trocar LC using an original new technique in 70 consecutive patients. A 10-mm trocar and a 5-mm trocar were inserted in the subumbilical and epigastrium positions, respectively. A 2-mm grasper forceps was inserted directly without a trocar below the costal margin. The fundus of the gallbladder was ligated and lifted up with a folded 0 silk string and a 16-gauge vessel cannula.


RESULTS
The mean operative time was 73.2 +/- 23.5 min. A third trocar was added in two cases. None of the patients required conversion of the procedure to an open cholecystectomy, and there were no intraoperative complications.


CONCLUSIONS
Based on our experience, we think that this technique is as safe and effective as the classic four-trocar technique; moreover, it has a cost benefit.
Mori
T
T
Department of Surgery, Osaka Prefectural Habikino Hospital, 3-7-1, Habikino, Habikino-City, Osaka 583-8588, Japan.
Ikeda
Y
Y
Okamoto
K
K
Sakata
K
K
Ideguchi
K
K
Nakagawa
K
K
Yasumitsu
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods* / Q000639:trends; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013997:Time Factors