scholarly journals EPIGASTRIC VS. UMBILICAL PORT FOR RETRIEVAL IN LAPAROSCOPIC CHOLECYSTECTOMY : WHICH IS BETTER

2020 ◽  
pp. 1-2
Author(s):  
Zayd Ashok ◽  
Priyanka pant
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Standard Treatment ◽  
Single Incision ◽  
Technical Difficulty ◽  
Port Site ◽  
Post Operative Pain ◽  
Port Site Hernia ◽  
Day By Day ◽  
Site Pain

Background and aim - Cholilithiasis is most common cause for cholecystectomy. These days laparoscopic cholecystectomy is the standard treatment for cholilithiasis. Extraction of gall bladder is an important cause for post operative pain after cholecystectomy. Laparoscopic cholecystectomy is still evolving, the number of ports are being reduced day by day. From standard four port to single incision and using natural orifices (NOTES). This study was done to determine whether the patients undergoing gall bladder retrieval via umbilical port was associated with more complications than epigastric port in a standard four port laparoscopic cholecystectomy. Method - 400 patients were selected for the study and were randomly allocated into 2 groups. Postoperatively, port-site pain score assessed at 2, 6, 12, and 24 hours by visual analog scale (VAS) score both for the epigastric and umbilical ports in all the patients and other variables are assesed accordingly and the collected data were analyzed by using SPSS version 22. Result - The postoperative pain and spillage was more in retrieval via epigastric port with only mild technical difficulty and relatively higher incidence of port site hernia from the retrieval port in retrieval via umbilical port.

scholarly journals SURGICAL AUDIT - LAPAROSCOPIC CHOLECYSTECTOMY IN A FREE CAMP AT PRIVATE SECTOR HOSPITAL

2020 ◽  
Vol 11 (2) ◽  
pp. 16-20
Author(s):  
Dr. Abdul Ghani Soomro
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
Port Site ◽  
Bladder Injury ◽  
Safe Procedure ◽  
Trocar Site ◽  
Port Site Hernia ◽  
Surgical Audit

BACKGROUND & OBJECTIVE: Laparoscopic Cholecystectomy is usual method for the treatment of gall bladder stone disease and is practiced all over the world due to many benefits like fasten the recovery time. Furthermore, it reduced the post-operative pain and period of hospital stay. To conduct Surgical Audit and evaluate safety of Laparoscopic cholecystectomy. METHODOLGY: This prospective study was conducted in a private hospital at Hyderabad during free camps of Laparoscopic Cholecystectomy. Four camps were arranged in 2016 - 2019. Total number of 190 patients  underwent Laparoscopic Cholecystectomy during the study period. The patient's age falls between 12–65 years. A detailed history, relevant investigation and Cardiac fitness were evaluated. All patients underwent four ports Lap-Chole. Data was collected assessed and audit was performed and safety was evaluated. RESULTS: Total 190 patients operated females 88.45% and males 11.55%. 115 (60.50%)were in  the range of 30-35 years followed by 55 (28.95%)patients in the range of 40-50 years.8 (4.20%) patients were converted to open cholecystectomy, 4 due to bleeding from liver bed, 3 patients due to difficult dissection in calots triangle and 1 due to Empyema of gall bladder.10 patients (5.50%) had Trocar site bleeding, 10 patients (5.50%) had gall bladder injury, in 4 cases had spillage of stones and 72 patients (38.50%) developed umbilical port site infection 1 patient develop port site hernia. No mortality was recorded in this study. CONCLUSION: Our Surgical Audit proves that Laparoscopic Cholecystectomy is a safe procedure on the basis of only 4.2% intra operative and 5.5% postoperative complications and gaining wide spread popularity among our population due to less pain, less hospital stay. We recommend other private hospitals to extent such services to our poor population with symptomatic cholelithiasis.

scholarly journals An Unusual Incarcerated Port Site Hernia due to retained partial gall bladder with stones - A case report.

KYAMC Journal ◽  
2013 ◽  
Vol 3 (2) ◽  
pp. 309-311
Author(s):  
Mohd. Farid Hossain ◽  
Md. Rakib Uddin ◽  
Raihanul Islam Emon ◽  
Md. Manhbur Rashid Sarkar
Keyword(s):  
Emergency Department ◽  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Gall Bladder ◽  
Port Site ◽  
Primary Surgery ◽  
Incomplete Removal ◽  
Port Site Hernia ◽  
Early Features

A 50 years old lady presented to the Emergency department with what appeared to be a strangulated infraumbilical hernia. She was explored and found to have an unexpected, unusual diagnosis -- incarcerated port site hernia with early features of strangulation. There was fundic part of gall bladder loaded with stones in the center of hernial contents. Gall bladder was surrounded by inflammed pad of omentum. The defect and the mass was approximately 6-8 cm below the umbilical port site incision scar of laparoscopic cholecystectomy, performed 13 years back. Excision of the inflammed hernial contents and Herniorraphy was performed. Patient recovered completely. Complications related to introduction of ports and incomplete removal of gall bladder may present in various ways and sometimes many years after the primary surgery. Methods of reducing the risk of such complications and pathogenesis of hernia in this case are discussed. KYAMC Journal Vol. 3, No.-2, January 2013, Page 309-311 DOI: http://dx.doi.org/10.3329/kyamcj.v3i2.15174

scholarly journals Complications of Laproscopic Cholecystectomy in Patients of Acute Cholecystitis

2021 ◽  
Vol 15 (8) ◽  
pp. 2477-2479
Author(s):  
Haseena Rehman ◽  
Gul Lalley ◽  
Gul Sharif ◽  
Asim Shafi ◽  
Asif Mehmood ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Wound Infection ◽  
Acute Cholecystitis ◽  
Port Site ◽  
Treatment Procedure ◽  
Post Operative Pain ◽  
Port Site Hernia ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Bladder Diseases ◽  
History Of

Objective: To determine the complications of laparoscopic cholecystectomy in patients of acute cholecystitis. Study Design: Prospective study. Place & Duration: Department of Surgery, Lady Reading Hospital, Peshawar for duration of six months from January 2020 to June 2020. Methods: Total 120 patients of both genders with ages 20 to 60 years were included in this study. Patients’ detailed demographics were recorded after taking written consent. Patients with history of abdominal surgery were excluded. All the patients underwent laparoscopic cholecystectomy for gall bladder diseases. Post-operative pain was analyzed by VAS. Complications were recorded at 5th postoperative day. Data was analyzed by SPSS 24.0. Results: Out of 120 patients 30 (25%) patients were males and 75% patients were females. Most of the patients 50 (41.67%) were in the age group 31 to 40 years followed by 37 (30.83%) patients were ages between 41 to 50 years. 70 (58.33%) patients had surgical size port incision was 5mm and 50 (41.67%) patients had 10mm. Mean pain score was 2.24+1.1 at 5th postoperative day. Wound infection was found in 10 (8.33%). Port site hernia was found in 12 (10%). Conclusion: Laparoscopic cholecystectomy is safe and effective treatment procedure with no major complications. Keywords: Laparoscopic Cholecystectomy, Acute Cholecystitis, Wound Infection, Port Site Hernia, Pain

scholarly journals POSTOPERATIVE PORT-SITE PAIN AFTER GALL BLADDER RETRIEVAL FROM EPIGASTRIC VS UMBILICAL PORT IN LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 9 (09) ◽  
pp. 333-337
Author(s):  
Neel Ketu ◽  
Santosh Kumar ◽  
Prem Prakash
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Tertiary Care ◽  
Port Site ◽  
Adult Patients ◽  
P Value ◽  
Care Hospital ◽  
Duration Of Surgery ◽  
Elective Laparoscopic Cholecystectomy ◽  
Site Pain

Objective: To determine whether gall bladder (GB) retrieval from umbilical port is associated with more pain at port site as compared to GB retrieval from epigastric port in adult patients undergoing four port elective laparoscopic cholecystectomy at a tertiary care hospital. Methods: Adult patients, who were undergoing elective laparoscopic cholecystectomy during a six-month period in 2010 at our institute, were randomized to either group A (n = 60, GB retrieval through epigastric port) or group B (n = 60, GB retrieval through umbilical port). VAS for pain was assessed by a registered nurse at 1, 6, 12, 24 and 36 h after surgery. Results: The VAS for pain at umbilical port was less than epigastric port at 1, 6, 12, 24 and 36 h after surgery (5.9 ±1.1 vs. 4.1± 1.5, 4.6± 0.94 vs. 3.5± 1.05, 3.9± 0.85 vs. 2.4± 0.79, 3.05± 0.87 vs. 2.15± 0.87, respectively) and the difference was statistically significant (p-value < 0.001). Multiple linear regression was done for port site pain at 24 h and the VAS at umblical port was less than epigastric port with VAS difference of 0.9 after adjusting for age, sex, duration of surgery and additional analgesia use (r 2 =0.253, p-value < 0.001). Conclusion: Gall bladder retrieval from umbilical port is associated with lower port site pain than GB retrieval from epigastric port in patients undergoing elective laparoscopic cholecystectomy. We recommend umbilical port for gall bladder retrieval.

scholarly journals A comparative study of the incidence of pain and infection in gall bladder extraction via umbilical and epigastric port

2017 ◽  
Vol 4 (2) ◽  
pp. 747 ◽  
Author(s):  
Jugendra Pal Singh Shakya ◽  
Neelabh Agrawal ◽  
Arun Kumar ◽  
Akash Singh ◽  
Bhupesh Gogia ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Randomized Study ◽  
Port Site ◽  
P Value ◽  
Medical College ◽  
Post Operative Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Background: In laparoscopic cholecystectomy, gall bladder extraction via different ports has always been a matter of concern for the surgeons. This study is designed so as to determine the difference in the rate of pain and infection in gall bladder extraction via umbilical and epigastric port.Methods: A prospective randomized study was done from January 2015 to December 2015 at S. N. Medical College, Agra in which 200 patients of cholelithiasis were considered. The patients were randomly selected in the operation theatre for gall bladder extraction via epigastric port (designated as Group-A with n = 100 patients) and gall bladder extraction via umbilical port (designated as Group-B with n = 100 patients).Results: Post-operative pain at 24 hours, in terms of VAS was 3.67±1.42 in Group-A while 2.47±1.17 in Group-B with 10 being the worst pain. The p-value was calculated as .000048. The result is significant at p< .05. A total of eight patients out of two hundred patients suffered port site infections amongst which five were from Group-A (5%) and three were from Group-B (3%).Conclusions: This study thus indicates that in laparoscopic cholecystectomy, gall bladder retrieval through the umbilical port is a better alternative to gall bladder extraction via epigastric port in terms of post-operative pain and port site infection. Our study recommends gall bladder extraction via umbilical port rather than epigastric port. 

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals Comparative study of standard laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy: outcome and complications

2019 ◽  
Vol 7 (11) ◽  
pp. 4310
Author(s):  
Kirti Savyasacchi Goyal ◽  
Maneshwar Singh Utaal ◽  
Pramod Kumar Bhatia
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Operative Time ◽  
Gall Bladder Disease ◽  
Single Incision ◽  
Intraoperative Complications ◽  
Single Incision Laparoscopic Surgery ◽  
Bladder Disease ◽  
Standard Laparoscopic Cholecystectomy ◽  
Single Incision Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy (LC) has evolved to be as gold standard treatment for gall bladder disease and is the most common laparoscopic procedure performed worldwide. In recent times, the innovative techniques of Natural orifice Transluminal Endoscopic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS) have been applied as a step forward towards scar less surgery with added benefits of less pain and less analgesic requirement, shorter hospital stay, quick return to work.Methods: A retrospective study of 50 patients admitted with gall bladder disease through outdoor for laparoscopic cholecystectomy from November 2018 to January 2019 in Maharishi Markandeshwar Institute of Medical Sciences and Research Mullana (AMBALA) were randomized into two groups of  25 each for Single Incision Laparoscopic Cholecystectomy (SILC) and standard laparoscopic cholecystectomy (LC) comparing the operative time, outcome and  complications.Results: 50 patients admitted to MMIMSR Mullana from November 2018 to January 2019 with gall bladder disease were divided into two groups of 25 each who underwent three port SILC and four port laparoscopic cholecystectomy (4PLC). The average intra-operative time in SILC (80.56 mins) was significantly more than standard laparoscopic cholecystectomy. The average length of stay in the hospital for SILC was 1.8 days (1-3 days), was significantly less than in standard four port laparoscopic cholecystectomy. Incidence of Intraoperative complications were more in SILC than standard LC.Conclusions: SILC as the newer novel technique had better outcomes in terms of cosmesis, early discharge, shorter stay at hospital.

Frequency of Port Site Wound Infection with and Without End Gloves Techniques of Retrieval of Gallbladder in Pouch

2021 ◽  
Vol 15 (12) ◽  
pp. 3399-3401
Author(s):  
Naeem Ahmed ◽  
Maryum Saleem Raha ◽  
Uzma Shamim Seth ◽  
Mohammad Taha Kamal ◽  
Anum Nawazish Al ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
General Surgery ◽  
Port Site ◽  
Medical Institute ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Group I ◽  
Significant Difference

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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