scholarly journals Comparison of Clipless and Clipped Laparoscopic Cholecystectomy at Nishtar Hospital Multan, Pakistan

2020 ◽  
Vol 9 (4) ◽  
pp. 275-279
Author(s):  
Dr Abdul Manan ◽  
Dr Ashar Ahmad Khan ◽  
Irfan Ahmad ◽  
Dr Muhammad Usman ◽  
Tariq Jamil ◽  
...  

Objective:  To compare the efficacy of clipless cholecystectomy using harmonic scalpel and clipped conventional laparoscopic cholecystectomy. Study design: A randomized control trial. Place and duration of study: Department of general surgery at Nishtar Hospital Multan, from October 1st 2019 to March 31st 2020. Methodology: Total 188 patients of gallstone related cholecystitis were enrolled in the study and were selected using non-probability consecutive sampling technique. All the patients were randomly divided into two equal groups. One group was designated for clipless and the other for conventional clipped laparoscopic cholecystectomy. Age, gender, duration of cholecystitis, duration of Procedure, hospital stay, usefulness in difficult procedures and biliary leakage were recorded for all the patients. Data was entered in SPSS version 23 and analyzed. Results: Operation time was 28.35±7.92 minutes and 21.15±4.47 minutes in clipped and unclipped surgery, respectively (p<0.001). Hospital stay was 2.37±0.60 days in clipped surgery group and 1.71±0.74 days in clipless surgery group (p<0.001). Biliary leakage was reported in 2(2.1 %) patients of the clipped group and 1(1.1%) patients of the unclipped group (p = 0.561). Usefulness of the procedure in difficult cases was documented in 0 (0.0%) of the clipped procedures and in 8 (8.5%) of the clipless procedures (p=0.004). Conclusion: As witnessed from this study, it can be concluded that clipless surgery is a better option as compared to the clipped conventional laparoscopic Cholecystectomy as former is associated with shorter operation time, shorter hospital stay and better usefulness in difficult cases.

2018 ◽  
Vol 24 (3) ◽  
pp. 139
Author(s):  
Servet Gencdal ◽  
Emre Ekmekci

<p><strong>Objective:</strong> To compare the intraoperative characteristics and postoperative results of mini laparoscopic and conventional laparoscopic surgeries performed for surgical sterilization.</p><p><strong>Study Design:</strong> This retrospective study was conducted to compare the conventional and mini laparoscopic tubal ligation for surgical tubal sterilization. In total of 39 women, 22 in the conventional laparoscopy and 17 in the mini laparoscopic surgery group participated in the study. The main outcome measures were total operation time, amount of bleeding, intraoperative complications, skin scar formation with patient scale and observer scale and length of hospital stay. </p><p><strong>Results:</strong> Demographical findings did not differ between the two groups. Similarly, rates of intraoperative complications, conversion to laparotomy, length of hospital stay, pre and postoperative hematocrit levels were not significantly different between the groups. Both patient and observer POSAS scores were better in mini laparoscopic surgery group. </p><p><strong>Conclusion:</strong> Mini laparoscopic surgery seems a safe and feasible alternative to conventional laparoscopy for surgical tubal sterilization.</p>


2020 ◽  
pp. 1-3
Author(s):  
Vinaya Ambore ◽  
Sandeep Darbastwar ◽  
Nikhil Dhimole ◽  
Gurpreet Singh ◽  
Chidananda H

Background Single Incision Laparoscopic Surgery, is an alternative to conventional multi-port laparoscopic surgeries with the aim to reduce complications associated with multiple incisions and increase cosmesis. In this study we aim to compare the single incision approach vs the conventional approach for laparoscopic cholecystectomy. Materials We conducted a prospective cohort study at a tertiary care set up, comparing 30 patients each undergoing conventional laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy. Data recorded included demographics, intra-operative and post-operative course, duration of hospital stay, hospital cost and expenditure. Results We found out that single incision laparoscopic cholecystectomy is associated with longer operative time (65 mins vs 55 mins), a longer hospital stay (5 days vs 2.5 days) and higher hospital expenditure. Intraoperative complications like bleeding and inadvertent gall bladder perforation were more in the single incision group (10% vs 3.3%), and on follow up, 2 patients from the single incision group had surgical site infection and port site herniation compared to none from the conventional laparoscopy group. The patients reported better cosmetic outcome in the single incision laparoscopic cholecystectomy group. Conclusion Single incision laparoscopic cholecystectomy is better than conventional laparoscopic cholecystectomy with regards to final cosmesis and quality of life parameters, however, it comes with higher economic burden, longer operative times and untoward intra-operative and post-operative events.


2021 ◽  
Vol 15 (12) ◽  
pp. 3399-3401
Author(s):  
Naeem Ahmed ◽  
Maryum Saleem Raha ◽  
Uzma Shamim Seth ◽  
Mohammad Taha Kamal ◽  
Anum Nawazish Al ◽  
...  

Background: The gallbladder is a hollow organ that sits just beneath the right lobe of the liver. Chief functioning of gallbladder is to store gall, also known as bile that is required for digestion of food. Removing gallbladder through small incision in the abdomen is called laparoscopic cholecystectomy. Among benefits of cholecystectomy are decreased need for postoperative analgesia, decreased postoperative pain and shortened hospital stay from 1 week to less than 24 hours. Objective: To compare the frequency of port site wound infection with and without endogloves techniques of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis. Design: It was a randomized controlled trial. Study Settings: This study was conducted at Department of General Surgery, Midland Doctors Medical Institute Tandali Muzaffarabad from July 2019 to July 2021 Material and Methods: A total of 260 cases who fulfilled inclusion criteria were enrolled in the study through wards of Department of General Surgery. Written informed consent was obtained from all the patients. Two groups were made by random division of patients. Conventional laparoscopic cholecystectomy was performed in patients of group I. Through umbilical port gall-bladder was retrieved in these patients, exactly spot on by a sterile surgical hand glove endobag. Vicryl “O” with J-shaped needle was used to close 10mm umbilical port (fascial defect) and 5mm ports were conventionally closed. In patients of group II, conventional laparoscopic cholecystectomy was performed and gall-bladder was retrieved as in patients of group I but without using surgical sterile hand glove endobag. Results: The mean age of the patients in study group was 48.09±15.402 years and in control group it was 47.51±16.48 years. Male to female ratio was 1.06:1. The post-op wound infection was found in 11 (4.23%) patients. Statistically significant difference was found in groups (P<0.05). Conclusion: The use of endoglove technique of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis is safe, cheap, simple and potentially reduces significant port site wound infection compared to without endogloves. Keywords: Laparoscopic Cholecystectomy, Endoglove, Gallbladder (GB).


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