Mindener Technik der minimalinvasiven Gallenblasenoperation-Operationstechnik mit kaum sichtbaren Narben (Beobachtungs-Studie)
Loading...
Files
Date
Authors
Publisher
Philipps-Universität Marburg
Supervisors
Abstract
Background:
Presently, there is a worldwide attempt to further decrease abdominal trauma and optimize
the cosmetic results after laparoscopic cholecystectomy. In a prospective observational
study, the combined suprapubic and intraumbiilical cholecystectomy in Minden modification
(MI- CHE) was evaluated.
Method:
The MI- CHE is performed via a 5mm intraumbilical trocar through which a 30° optic is
introduced. A 10 mm trocar that is later used as a camera port for the long 45° laparoscopic
optic is then instilled in the suprapubic area under visual control, alongside of a
long curved grasper. An auxiliary instrument may be punctured into the right abdominal
flank without a trocar. Retrieval of the gall bladder is carried out through the suprapubic
incision.
Patients:
Two surgeons within this study operated 30 consecutively selected patients presenting
with non-complicated symptomatic cholelithiasis. Clinical data was collected during the
perioperative phase and least 3 months after surgery.
6 selected independent judges including 2 independent surgeons, 2 beauticians and 2 patients
awaiting surgery due to biliary lithiasis analyzed 18 standardized photos of each
patient taken peri- and postoperatively.
Results:
Between April 2009 and February 2010 two surgeons successfully operated 30 patients, 9
males and 21 females. The average operating time required by both surgeons was 73.06
minutes (65.75 vs. 87.7) minutes. No conversion to 4- trocar laparoscopic or open cholecystectomy
was nessesary. No complications were observed.
Perioperative data (operation time, pain, mobilization, enteralization, and duration of
hospital stay) was within the range found in literature concerning laparoscopic cholecystectomy.
Cosmetic results:
In all 9 males and 21 females, the scars were barely visible after 3 months. The only visible
scar on most patients was the 10 mm incision in the suprapubic area, which was not
visible when underwear was normally worn. All the independent judges agreed that the 11
cosmetic results after 3 months were very good with an average of 7.35, 7.92, 8.2, 8.39,
8.45 and 8.98 on the Likert-scale (from 0= “very bad” 10= “very good”). The patient's
subjective judgment of the cosmetic results was 9.6 on average (SD 0,76) and 9 in median
(range 6-10) on the Likert-scale with an optimum value of 10. All Patients involved
admitted they would select this method again.
Conclusion:
MI- CHE has very good cosmetic results and has shown good acceptance among male
and female patients. It seems to be a safe and effective alternative to the traditional laparoscopic
cholecystectomy with comparatively good perioperative results. Due to the nature
of the observational study, this remains a hypothesis at present.
Review
Metadata
Contributors
Supervisor:
Dates
Created: 2012Issued: 2012-06-14Updated: 2012-08-15
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Minden-CholecystectomyMindener-Cholezystektomie
DFG-subjects
Cholezystektomie
DDC-Numbers
610
show more
Gitei, Esther (102045217X): Mindener Technik der minimalinvasiven Gallenblasenoperation-Operationstechnik mit kaum sichtbaren Narben (Beobachtungs-Studie). : Philipps-Universität Marburg 2012-06-14. DOI: https://doi.org/10.17192/z2012.0228.
License
This item has been published with the following license: In Copyright