Colecistectomía laparoscópica transumbilical. Resultados con el dispositivo de gel y revisión de la literatura

Triple umbilical incision for videlaparoscopic cholecystectomy

“…La utilización de un hilo externo para exponer el fondo vesicular, llamado también método de marionetas (4)(5)(6)(7)(8)(9)(10)(11)(12) , nos resulta útil si se lo coloca no precisamente en el fondo vesicular, porque siendo así, no se logra una buena tracción y exposición de la vía biliar. Algunos autores por eso desechan este método y utilizan mini pinza adicional, retracción con alambre de Kirschner o uso de imanes para una mejor exposición (10)(11)(12)(13) .…”

“…Este término abarca a todos los procedimientos que son realizados a través de una incisión única (habitualmente entre 18 y 50 mm), y engloba a múltiples modalidades tales como: las técnicas que emplean dispositivos multi-puertos de diferentes empresas dedicadas al rubro médico (Triport, AirSeal, Uni-X, SILs, X-Cone, Spider, etc.) (5)(6)(7) . Para la colocación de algunos dispositivos uno debe realizar incisiones en promedio de 3-5 cm 5-6, y en todos ellos tendríamos dos grandes limitaciones: la aglomeración e interferencia de los instrumentos y la disminución de la calidad de la triangulación y exposición del área quirúrgica, además algunos demandan la realización de una incisión más amplia (5-6-9) .…”

Triple Umbilical Incision for Videlaparoscopic Cholecystectomy

“…The two most important limitations in most single-port laparoscopic surgery techniques are associated with decreased triangulation, exposure of the surgical area, and interference with the instruments inside the patient. 6,10,11 The use of an external thread to expose the vesicular fund, also called the puppet method, [4][5][6][7][8][9][10][11][12] it is useful to us if is not placed precisely in the vesicular fund, because being so, good traction and exposure of the bile duct is not achieved. Some authors therefore discard this method and use additional mini clamp, retraction with Kirschner wire or use of magnets for better exposure.…”

“…So far, numerous procedures with multiple acronyms have been reported in the literature, however, the most acceptable seems to be LEES (From English: laparo-endoscopic single-site surgery) and whose translation into Spanish is laparoscopic surgery through a single port. [4][5][6] This term covers all procedures that are performed through a single incision (usually between 18 and 50 mm) and it includes multiples modalities such as: techniques that use multi-ports devices of different companies dedicated to the medical field (TriPort, Air Seal, Uni-X, SILs, X-Cone, Spider, etc.) [5][6][7] For the placement of some devices one must make incisions on average of 5 cm.5-6 and in all of them we would have two major limitations: the agglomeration and interference of the instruments and the decrease in the quality of the triangulation and exposure of the surgical area, in addition some demand the realization of a broader incision.…”

“…[4][5][6] This term covers all procedures that are performed through a single incision (usually between 18 and 50 mm) and it includes multiples modalities such as: techniques that use multi-ports devices of different companies dedicated to the medical field (TriPort, Air Seal, Uni-X, SILs, X-Cone, Spider, etc.) [5][6][7] For the placement of some devices one must make incisions on average of 5 cm.5-6 and in all of them we would have two major limitations: the agglomeration and interference of the instruments and the decrease in the quality of the triangulation and exposure of the surgical area, in addition some demand the realization of a broader incision. 5,6,9 The technique that we present does not scape of these inconveniences, but it is economical to not use any devices that is placed in the umbilicus, nor the use of special instruments the objective is achieved which is the removal of the gallbladder and the aesthetic and cosmetic result is very acceptable since it does not leave visible marks.…”