title: Advantages of minimal incision laparoscopic cholecystectomy.
abstract: BACKGROUND
  Modifications to conventional laparoscopic cholecystectomy (CLC) are aimed at decreasing abdominal wall trauma and improving cosmetic outcome. Although single-incision laparoscopic surgery (SILS) provides excellent cosmetic results, the procedure is technically challenging and expensive compared to the conventional laparoscopic approach.
  
  
  OBJECTIVE
  To describe a novel, hybrid technique combining SILS and conventional laparoscopy using minimal abdominal wall incisions.
  
  
  METHODS
  Fifty patients diagnosed with symptomatic cholelithiasis were operated using two reusable 5 mm trocars inserted through a single 15 mm umbilical incision and a single 2-3 mm epigastric port. This technique was clubbed "minimal incision laparoscopic cholecystectomy" (MILC).
  
  
  RESULTS
  MILC was completed in 49 patients (98%). In five patients an additional 3 mm trocar was used and in 2 patients the epigastric trocar was switched to a 5 mmtrocar. The procedure was converted to CLC in one patient. Mean operative time was 29 minutes (range 18-60) and the average postoperative hospital stay was 22 hours (range 6-50). There were no postoperative complications and the cosmetic results were rated excellent by the patients.
  
  
  CONCLUSIONS
  MILC is an intuitive, easy-to-learn and reproducible technique and requires small changes from CLC. As such, MILC may be an attractive alternative, avoiding the cost and complexity drawbacks associated with SILS.
authors: Nasser
authors: N
authors: Sakran
authors: David
authors: D
authors: Goitein
authors: Asnat
authors: A
authors: Raziel
authors: Dan
authors: D
authors: Hershko
authors: Amir
authors: A
authors: Szold
mesh_terms: D034861:Abdominal Wall; D000293:Adolescent; D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D061646:Operative Time; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D055815:Young Adult