title: Three ports placed in the linea alba of the abdomen (three-midline-ports technique): an alternative approach for laparoscopic cholecystectomy.
abstract: BACKGROUND
  Laparoscopic cholecystectomy is the commonest operation performed laparoscopically worldwide. In this study, we compared a three-midline-ports approach with the standard "French" method for laparoscopic cholecystectomy.
  
  
  METHODS
  A prospective, randomized study was performed between March 2010 and January 2011. One hundred consecutive patients undergoing elective cholecystectomy for symptomatic gallstones were included. The patients were randomized into two groups: those patients undergoing laparoscopic cholecystectomy following the "French" technique with three ports (Group 1) and those ones undergoing the three-midline-ports approach (Group 2).
  
  
  RESULTS
  Mean operation time was 70.1±19.15 minutes in Group 1 versus 65.9±17.03 minutes in Group 2 (not significant). Complications appeared in 1 patient (2%) in each group (not significant). There was no mortality. Median hospital stay was 1.5 days in both groups. Median postoperative pain evaluated by visual analog scale was 4 (range, 1-7) in Group 1 and 2.5 (range, 0-4) in Group 2 (P=.002). In both groups, the most painful port was the subumbilical one, followed by the 10-mm port and then the 5-mm one. The visual analog scale evaluation separately of the 10-mm port was 2.5 in Group 1 versus 1.5 in Group 2 (P=0.04).
  
  
  CONCLUSIONS
  The three-midline-ports approach is a feasible technique, safe and easy to implement, associating lower postoperative pain than the standard "French" approach.
authors: Department of Surgery, General University Hospital Elche, Alicante, Spain. jruiztovar@gmail.com
authors: Jaime
authors: J
authors: Ruiz-Tovar
authors: Irene
authors: I
authors: Ortega
authors: Jair
authors: J
authors: Santos
authors: Carolina
authors: C
authors: Llavero
authors: Liliana
authors: L
authors: Sosa
authors: Laura
authors: L
authors: Armañanzas
authors: Salvador
authors: S
authors: García
authors: Rafael
authors: R
authors: Calpena
mesh_terms: D000005:Abdomen; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies