caa a22 4500 475778723 CHVBK 20180406123638.0 cr unu---uuuuu 170329e20000101xx s 000 0 eng 10.1007/s004649900006 doi (NATIONALLICENCE)springer-10.1007/s004649900006 Minimizing ports to improve laparoscopic cholecystectomy [Elektronische Daten] [P. Leggett, R. Churchman-Winn, G. Miller] Background: Minimizing the number and scope of ports used to perform laparoscopic cholecystectomy attempts to build on the improvements in postoperative pain control, rapid return to activity and work, patient satisfaction, and cosmetic result achieved by the laparoscopic method. Methods: We studied 141 patients in two sequential studies: the first a prospective randomized trial with 41 patients, and the second an examination of the more minimal procedure in 100 patients. In the randomized trial, patients underwent laparoscopic cholecystectomy with three ports: three 5-mm ports or two 10-mm ports and one 5-mm port. The 100 patients underwent the three 5-mm port procedure. Results: In the randomized trial, differences were not statistically significant. However, on the average, the group with three 5-mm ports required less medication over less time, had less postoperative pain, and took less time to return to activity than the second group with larger ports. A statistically significant difference was found in incisional pain between the smaller group (21 patients) with two 10-mm ports and one 5-mm port and the larger group (100 patients) with three 5-mm ports, whether the measure was overall incisional pain (p=0.014) or a comparison based on specific ports (p=0.001). The percentage of cases requiring port enlargement to remove the gallbladder was not significantly different between the groups. There were no conversions to an open procedure, no fourth trocars added, and no complications. No patient required overnight hospitalization. Conclusions: Reducing the number and size of ports in laparoscopic cholecystectomy sustains or enhances the improvements initiated by performing laparoscopic rather than open cholecystectomy. In a comparison of microlaparoscopic procedures, patients undergoing the procedure with the shorter incisions experienced significantly less pain. Springer-Verlag, 2000 Laparoscopic cholecystectomy nationallicence Laparoscopic surgery nationallicence Laparoscopy nationallicence Microlaparoscopic cholecystectomy nationallicence Leggett P. Department of Surgery, University of Texas-Houston Northwest Medical Center, 800 Peakwood, Suite 8B, 77090, Houston, TX, USA aut Churchman-Winn R. Department of Surgery, University of Texas-Houston Northwest Medical Center, 800 Peakwood, Suite 8B, 77090, Houston, TX, USA aut Miller G. Division of Surgery, Private Practice Clinic, Gold Coast Hospital, Southport, Australia aut Surgical Endoscopy Springer-Verlag 14/1(2000-01-01), 32-36 0930-2794 14:1<32 2000 14 464 https://doi.org/10.1007/s004649900006 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004649900006 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leggett P. Department of Surgery, University of Texas-Houston Northwest Medical Center, 800 Peakwood, Suite 8B, 77090, Houston, TX, USA aut NATIONALLICENCE 700 1- Churchman-Winn R. Department of Surgery, University of Texas-Houston Northwest Medical Center, 800 Peakwood, Suite 8B, 77090, Houston, TX, USA aut NATIONALLICENCE 700 1- Miller G. Division of Surgery, Private Practice Clinic, Gold Coast Hospital, Southport, Australia aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/1(2000-01-01), 32-36 0930-2794 14:1<32 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer