The Effectiveness of a Snake Liver Retractor during Needlescopic Grasper Assisted Sinlge-Incision Laparoscopic Cholecystectomy in the Aspect of Securing a Critical View of Safety.
- Author:
Myung Guen CHA
1
;
Tae Seok KIM
;
Kee Hwan KIM
;
Chang Hyeok AN
;
Jeong Soo KIM
Author Information
1. Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea. keehwan@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Single incision laparoscopic cholecystectomy;
Liver retractor;
Critical view of safety
- MeSH:
Achievement;
Bile;
Bile Ducts;
Cholecystectomy;
Cholecystectomy, Laparoscopic;
Cholecystitis, Acute;
Humans;
Intraoperative Complications;
Korea;
Length of Stay;
Liver;
Operative Time;
Snakes;
Traction
- From:Journal of Minimally Invasive Surgery
2013;16(3):34-38
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Limited traction has been an obstacle in the advancement of single incision laparoscopic cholecystectomy (SILC). Adequate retraction is necessary for safe performance of a cholecystectomy. In this study, we introduce our method for securing CVS for prevention of bile duct injury during performance of SILC and evaluated the effectiveness of the snake liver retractor. METHODS: A total of 148 patients who underwent needlescopic assisted SILC (nSILC) from February 2011 to February 2012 at Uijeongbu St. Mary's Hospital, Uijeongbu, Korea were analyzed. Patients were categorized into two groups: G roup I consisted of patients who underwent nSILC without use of a snake liver retractor from February 2011 to October 2011 (n=51) and group II consisted of patients who underwent nSILC using a snake liver retractor from October 2011 to February 2012 (n=97). Patient characteristics and operative outcomes were compared between groups in order to evaluate the effectiveness of use of a snake liver retractor during performance of SILC. RESULTS: There were no differences in age, sex, BMI, and history of previous abdominal surgery. However, more difficult surgeries for acute cholecystitis were performed in group II. Nevertheless, no differences in operative outcomes, such as operative time, rate of bile spillage, open conversion rate, intraoperative complication, and postoperative hospital stay were observed between groups. In addition, CVS identification time was rather shorter in group II, compared with group I. CONCLUSION: Results of this study showed that nSILC using a snake liver retractor can allow for achievement of CVS safely and for expansion of indication for SILC through improvement of exposure and obtaining adequate traction.
