Effect of laparoscopic cholecystectomy techniques on postoperative pain: a prospective randomized study

Abstract

PurposeMinimally invasive surgical technics have benefits such as decreased pain, reduced surgical trauma, and increased potential to perform as day case surgery, and cost benefit. The primary aim of this prospective, randomized, controlled study was to compare the effects of single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) procedures regarding postoperative pain.MethodsNinety adult patients undergoing elective laparoscopic cholecystectomy were included in the study. Patients were randomized to either SILC or CLC. Patient characteristics, postoperative abdominal and shoulder pain scores, rescue analgesic use, and intraoperative and early postoperative complications were recorded.ResultsA total of 83 patients completed the study. Patient characteristics, postoperative abdominal and shoulder pain scores and rescue analgesic requirement were similar between each group except with the lower abdominal pain score in CLC group at 30th minute (P = 0.04). Wound infection was seen in 1 patient in each group. Nausea occurred in 13 of 43 patients (30%) in the SILC group and 8 of 40 patients (20%) in the CLC group (P > 0.05). Despite ondansetron treatment, 6 patients in SILC group and 7 patients in CLC group vomited (P > 0.05).ConclusionIn conclusion, in patients undergoing laparoscopic surgery, SILC or CLC techniques does not influence the postoperative pain and analgesic medication requirements. Our results also suggest that all laparoscopy patients suffer moderate and/or severe abdominal pain and nearly half of these patients also suffer from some form of shoulder pain.

Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis

“…BMI was 26·6(2·1) kg/m 2 in the SILC group and 26·1(2·5) kg/m 2 in the MLC group. Twenty‐one studies excluded obese participants depending on the BMI. Twelve trials included only patients with an ASA grade of I or II and nine included only patients with ASA grade I–III.…”

Clinical outcomes of single incision laparoscopic surgery and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair

“…Several comparative studies have been performed for conventional laparoscopy and SILS. [910] The most important advantage of SILS has been reported as the improvement in cosmetic results. [11] Pain scores vary from lower to higher scores when compared to conventional laparoscopy.…”

Effect of intraperitoneal CO2 concentration on postoperative pain after laparoscopic cholecystectomy

“…To this end, we measured the intraperitoneal CO 2 concentrations after laparoscopic cholecystectomy and assessed postoperative pain on the VAS 6, 12, and 24 hours after surgery to identify the association between residual intraperitoneal CO 2 concentrations and postoperative pain. Postoperative laparoscopic cholecystectomy pain has 2 major components including abdominal pain (right upper quadrant pain, trocar site pain) and shoulder pain [ 14 ]. Although we initially intended to assess shoulder pain (referred pain) only, we expanded the scope to the overall postoperative pain, including shoulder pain, right quadrant pain, and trocar site pain in consideration of the incidence of referred pain in previous studies and of previous reports suggesting that patients would have difficulty in distinguishing between postoperative referred pain and overall pain.…”