title: Two-Port Laparoscopic Cholecystectomy: 18 Patients Human Experience Using the Dynamic Laparoscopic NovaTract Retractor.
abstract: OBJECTIVE
  The concept of reducing the number of transabdominal access ports has been criticized for violating basic tenets of traditional multiport laparoscopy. Potential benefits of reduced port surgery may include decreased pain, improved cosmesis, less hernia formation, and fewer wound complications. However, technical challenges associated with these access methods have not been adequately addressed by advancement in instrumentations. We describe our initial experience with the NovaTract™ Laparoscopic Dynamic Retractor.
  
  
  METHODS
  A retrospective review of all patients who underwent two-port laparoscopic cholecystectomy between 2013 and 2014 using the NovaTract retractor was performed. The patients were equally divided into three groups (Group A, B, C) based on the order of case performed.
  
  
  RESULTS
  Eighteen consecutive patients underwent successful two-port laparoscopic cholecystectomy for symptomatic cholelithiasis. Mean age was 39.9 years and mean body mass index was 28.1 kg/m(2) (range 21-39.4). Overall mean operative time was 65 minutes (range 42-105), with Group A of 70 minutes, Group B of 65 minutes, and Group C of 58 minutes (P = .58). All cases were completed laparoscopically using the retraction system, without a need for additional ports or open conversion. No intra- or postoperative complications were seen. All patients were discharged on the same day of surgery. No mortality found in this series.
  
  
  CONCLUSIONS
  The NovaTract laparoscopic dynamic retractor is safe and easy to use, which is reflected by acceptable operative time for a laparoscopic cholecystectomy using only two ports. The system allows surgical approach to mimic the conventional laparoscopic techniques, while eliminating or reducing the number of retraction ports.
authors.affiliation: Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine , New Haven, Connecticut.
authors.forename: Iswanto
authors.initials: I
authors.lastname: Sucandy
authors.affiliation: Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine , New Haven, Connecticut.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Nadzam
authors.affiliation: Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine , New Haven, Connecticut.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Duffy
authors.affiliation: Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine , New Haven, Connecticut.
authors.forename: Kurt E
authors.initials: KE
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D055815:Young Adult