Alternative Port Site Selection (APSS) for Improved Cosmesis in Laparoscopic Surgery

Cruz‐Muñoz, Nestor de la; Koniaris, Leonidas G.

doi:10.1007/s11605-010-1282-z

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…These results are in line with other research. 10,15,16,17,19 In contrast to research by, 11,13,19,20 which reported conversion to open surgery, intraoperative challenges, an extra port insertion in the upper abdomen, and long instruments, our study did not find any complications either during the procedure or following it. To reduce the pot size, 5-mm ports could be used in place of the left 10-mm connector.…”

Section: Discussioncontrasting

confidence: 99%

“…In addition, Incisional hernia and wound infection risk have both been linked to SILC. 9,10 In covert laparoscopic cholecystectomy we place the laparoscopic ports in less noticeable body regions, such as the bikini line, is known as alternative port site selection, and it may lead to even better cosmoses. Many Surgeons have expressed interest in doing LC by covert technique through using the modified bikini line method by using one umbilical trocar and three trocars implanted along the suprapubic line because it has many benefit as it hidden scar or reduced scar , lower costs, and the ability to apply the same laparoscopic principles as standard.…”

Section: Introductionmentioning

confidence: 99%

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Covert Access Laparoscopic Cholecystectomy: Our Single Center Preliminary Results

R.,

A.,

Mubarak

et al. 2024

Ain Shams Journal of Surgery

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Introduction: Conventional laparoscopic cholecystectomy involves four trocars incisions on the upper abdomen, which may result in unfavorable cosmetic results. The minimally invasive abdominal surgery has developed to reduce the number of ports, operating with a single incision and natural orifice operation. However, these methods are still expensive, difficult to implement and with questionable aesthetic results. The suprapubic approach presents as a simpler and cheaper alternative with good aesthetic results. This study aimed to improve the aesthetic results of laparoscopic cholecystectomy (LC) by using a bikini line ports as an alternative approach to make trocar scars invisible. The feasibility and safety of this technique were evaluated. Patients and methods:This study involved 28 patients with symptomatic cholelithiasis who underwent LC between June 2022 and June 2023. The procedure involved inserting a first trocar (10-12 mm, optical trocar) in the lower abdomen at the bikini line to the left of the midline, insufflation with CO2 and then the other two trocars were placed at the bikini line to the right and left of the first one.Results: Standard instruments were used to perform the surgery, and the mean operative time was 54.66 ± 14.1 min. No intraoperative or postoperative complications occurred, and the median follow-up was 24 weeks. The cosmetic results were satisfactory for all patients, as the use of only three ports in the bikini line completely hid the scars from the ports' incision. Conclusion:Covert Laparoscopic Cholecystectomy: Is a new minimally invasive technique that proved to be feasible and safe, with no significant complications, and satisfactory cosmetic results.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Covert Access Laparoscopic Cholecystectomy: Our Single Center Preliminary Results

R.,

A.,

Mubarak

et al. 2024

Ain Shams Journal of Surgery

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“…There was no need for any additional ports or long instruments. These findings are consistent with earlier research [8,10,13,14]. Other investigations [6,12,[15][16][17], on the other hand, conversion to open surgery, intraoperative complications, an extra port insertion in the upper abdomen, and long instruments were reported.…”

Section: Discussionsupporting

confidence: 92%

Bikini Line Approach for Cosmetic Laparoscopic Cholecystectomy

2022

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Four-port laparoscopic cholecystectomy (LC) is a standard procedure. Several alternative approaches have been described to make trocar scars invisible. This study describes and was successfully administered as a pilot for feasibility and safety of a bikini line port for better aesthetic results. In patients with symptomatic cholelithiasis undergoing LC between June 2021 and December 2021, bikini line ports were used in 67 patients. With the patient in the supine position, the first trocar (11 mm) was inserted into the abdomen through the umbilicus. The other three trocars were placed in the lower abdomen at the bikini line with the help of the camera. Standard instruments were used to perform the surgery. The mean operative time was 54.66 SD 14.1 min. No intraoperative or postoperative adverse events took place. The median follow-up for this cohort was 24 weeks. Cosmetic results were satisfactory for all patients. The use of one umbilical camera port and the other three ports in the bikini line in the lower abdomen completely hides the scars from the ports’ incision. The technique was quickly adopted by regular laparoscopic surgeons with usual instruments, much to the satisfaction of patients.

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“…This correlates with other reports. In addition, several recent studies showed that SA leads to less postoperative pain compared to CA [ 10 , 11 , 23 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy

Taha

Taha‐Mehlitz²,

Sternkopf

et al. 2022

JCM

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Currently, cholecystectomy is performed laparoscopically. While the conventional approach (CA) with four access ports persists, other methods seek to reduce trauma or to optimize cosmetic results. In this study, the safety and cosmetic outcome of a suprapubic approach (SA) were evaluated. Between 2015 and 2016, patients undergoing elective cholecystectomy either by CA or by a suprapubic approach (SA) at our institution were included. The cosmetic outcome, postoperative morbidity, operative time and length of stay were evaluated. Pictures of the site of intervention were taken 6–12 months postoperatively and rated on a scale from 1 (unsatisfying aesthetic result) to 5 (excellent aesthetic result). Five “non-medical” and five “medical” raters as well as one board-certified plastic surgeon performed the ratings. A total of 70 patients were included (n = 28 SA, n = 42 CA). The two groups did not differ in baseline characteristics (age, gender, BMI). The SA group showed a significantly better aesthetic outcome compared to the CA group 4.8 (4.8–4.9) vs. 4.2 (3.8–4.4), (p > 0.001). Medical raters: 4.0 (3.8–4.2) vs. 4.8 (4.6–5.0), (p < 0.001); non-medical raters: 4.2 (3.8–4.6) vs. 5.0 (4.8–5.0), (p < 0.001); plastic surgeon: 4.0 (4.0–4.0) vs. 5.0 (5.0–5.0), (p < 0.001). Fair interrater consistency was demonstrated with an ICC of 0.47 (95% CI = 0.38–0.57). No significant difference in the complication rate (1 (3.5%) in SA vs. 6 (14%) in CA, (p = 0.3)), or the operating time 66 (50–86) vs. 70 (65–82) min, (p = 0.3), were observed. Patients stayed for a median of three (3–3) days in the SA group and 3 (3–4) days in the CA group (p = 0.08). This study demonstrated that the suprapubic approach is an appropriate alternative to conventional laparoscopic cholecystectomy, presenting a better cosmetic outcome with a similar complication rate.

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Alternative Port Site Selection (APSS) for Improved Cosmesis in Laparoscopic Surgery

Cited by 11 publications

References 14 publications

Covert Access Laparoscopic Cholecystectomy: Our Single Center Preliminary Results

Covert Access Laparoscopic Cholecystectomy: Our Single Center Preliminary Results

Bikini Line Approach for Cosmetic Laparoscopic Cholecystectomy

Suprapubic Cholecystectomy Improves Cosmetic Outcome Compared to Classic Cholecystectomy

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