Description and Initial Experience with the “LIFT” (Less Incisions but Four Trocars) Technique for Laparoscopic Cholecystectomy

Picazo-Yeste, Joaquín-Salvelio; El-Khoury, Serge; Alansi, Ali Yahya; Malik, M. A.; Nelson, Ashwyn Anand; Mallaev, Said Islam; Reddy, P Karthik

doi:10.1089/lap.2018.0785

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…The level of cosmetic satisfaction is out of the scope of this paper, albeit it is noteworthy that in a previous study on laparoscopic cholecystectomy, we found that the intraumbilical approach provides a significant improvement from the cosmetical standpoint,40 Similarly, Lee and Hong30 evaluated the cosmetic satisfaction using a body image questionnaire with scores ranging from 0 to 44 (a high score corresponding to a high body image), and the cosmetic survey score was significantly higher in the transumbilical group than in the periumbilical group (36.8±5.2 vs. 33.2±5.2, P <0.001). However, other studies found that cosmetic results did not differ statistically between the transumbilical, infraumbilical, and supraumbilical groups 10.…”

Section: Discussionmentioning

confidence: 92%

Modified Intraumbilical Versus Infraumbilical Entry Method at Laparoscopy: A Cohort Study

Cuevas-Toledano¹,

Picazo-Yeste²,

Moreno-Sanz³

2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: There is no consensus on the optimal laparoscopic entry method. Whether a transumbilical or periumbilical incision is beneficial for the initial peritoneal access has been debated. These 2 methods have their own advocates, since each has its own benefits and disadvantages. Furthermore, the lack of consensus extends to the type of entry technique [Hasson, Veress needle (VN), direct trocar]. We have conducted a study comparing a modified intraumbilical technique (MIT), a novel method that combines a VN insertion through a modified direct-trocar access, with the standard infraumbilical VN technique. Our aim is to determine which technique is a better route for the initial umbilical trocar. Materials and Methods: A retrospective cohort study of 406 patients from a prospectively maintained database has been performed. Two cohorts of cases have been analyzed (VN=198; MIT=208). Primary outcomes were intraoperative access-related events, entry failure, and long-term wound complications. Clinical follow-up was performed at 1 and 6 months and yearly thereafter. Results: Subcutaneous emphysema, extraperitoneal insufflation, and difficult entry (>2 VN insertions) occurred more frequently in the VN group (P=0.011, 0.023, and 0.023, respectively). There were 5 (2.52%) failed entries in the VN group and none in the MIT group (P=0.085). Regarding postoperative complications, seroma of the wound occurred more frequently in the VN group (P=0.033). At a mean follow-up of 18.4 months, 13 (3.20%) trocar-site hernias were detected, equally distributed among both groups. Conclusions: MIT eliminates the risk of failed entries and some complications associated with the VN technique without an increase in umbilical wound infection and facilitates a proper closure of the umbilical incision to secure a low trocar-site hernia rate. Halfway between open and closed techniques for laparoscopic entry, MIT is a safe and feasible procedure that embodies the advantages of both methods and may constitute an advantageous alternative to the infraumbilical VN entry approach.

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Section: Discussionmentioning

confidence: 92%

Modified Intraumbilical Versus Infraumbilical Entry Method at Laparoscopy: A Cohort Study

Cuevas-Toledano¹,

Picazo-Yeste²,

Moreno-Sanz³

2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…En otro artículo realizado por Shehata y colaboradores (12) , se compara la factibilidad de la técnica TILC con la convencional en una población pediátrica, obteniendo como resultado un tiempo quirúrgico y de hospitalización postoperatoria equiparable, con disminución del dolor estadísticamente significativo a las 6 y 12 horas después de la cirugía, así como buenos resultados cosméticos, aunque alegan que esto último se considera una consecuencia natural relacionada a la disminución de las incisiones en la pared abdominal. En el estudio de Picazo-Yeste y colaboradores (13) , hacen uso de una técnica que se encuentra dentro de las llamadas "cirugías laparoscópicas estratégicas" llamada LIFT por sus siglas en inglés (menos incisiones pero 4 trócares), en la cual se colocan 2 trócares a nivel umbilical, uno epigástrico y otro en la fosa ilíaca derecha. En dicha separata se compara la técnica convencional con ésta nueva técnica, obteniendo resultados significativos respecto al dolor postoperatorio (al día 90) y claramente con mejor desenlace estético.…”

Section: Discussionunclassified

Colecistectomía laparoscópica de dos incisiones. Estudio experimental

Garnica

2022

Rev. Venez. Cir

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El tratamiento estándar de la patología vesicular es la colecistectomía laparoscópica, sin embargo, con el pasar del tiempo se ha venido modificando el método convencional haciéndolo cada vez menos invasivo. Objetivo: Demostrar la factibilidad y seguridad de la colecistectomía laparoscópica de dos incisiones (TILC) comparándola con la técnica clásica (CLC) en cuanto a variables tales como tiempo quirúrgico, dolor postoperatorio, estancia hospitalaria, complicaciones y resultado cosmético. Métodos: Se tomó una muestra prospectiva de pacientes y se dividió equitativamente en dos grupos, los que se intervenían por TILC y otros por CLC. Ambos grupos se cuantificaron las variables anteriormente mencionadas y se hizo un análisis estadístico de las mismas tomando como significativo un valor de p < 0.05. Resultados: Existe significancia estadística únicamente cuando se comparaba el dolor postoperatorio medido a las 24 horas del procedimiento y el desenlace estético percibido de manera objetiva por el propio paciente. El resto de las variables no mostraron diferencias importantes entre ambas técnicas. Conclusiones: La colecistectomía laparoscópica por dos incisiones es un procedimiento seguro y factible, comparable en tiempo operatorio, complicaciones y estancia hospitalaria, pero con mejoría del dolor y resultado cosmético del paciente.

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Description and Initial Experience with the “LIFT” (Less Incisions but Four Trocars) Technique for Laparoscopic Cholecystectomy

Cited by 2 publications

References 27 publications

Modified Intraumbilical Versus Infraumbilical Entry Method at Laparoscopy: A Cohort Study

Modified Intraumbilical Versus Infraumbilical Entry Method at Laparoscopy: A Cohort Study

Colecistectomía laparoscópica de dos incisiones. Estudio experimental

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