Open access for pneumoperitoneum during laparoscopic cholecystectomy (transumbilical vs. conventional)

Elmeligy, Hesham A.A.; Esmat, Mohamed E.; Elashry, Mohamed A.; Gomaa, Amr M.; Helmy, Ahmed H.

doi:10.4103/ejs.ejs_45_20

Open access for pneumoperitoneum during laparoscopic cholecystectomy (transumbilical vs. conventional)

Authors

Abstract

Background
The gold standard technique in the management of symptomatic gall bladder stones is laparoscopic cholecystectomy; it provides minimal postoperative pain, less hospital stay, and good cosmetic outcome. The placement of the umbilical trocar remains the most critical step. There are two common techniques, which are open and closed methods. Transumbilical technique is preferred as it includes a natural opening and is a fast and safe technique.
Objective
In this study, the authors compared transumbilical and the conventional supraumbilical and infraumbilical open methods access for pneumoperitoneum during laparoscopic cholecystectomy regarding the time for port site entry, the time for port site closure, postoperative pain, and intraoperative and postoperative complications.
Patients and methods
This prospective comparative study was conducted on 160 cases, candidates for laparoscopic cholecystectomy, divided into two groups, that is, group A (transumbilical technique) and group B (supraumbilical and infraumbilical technique), starting from October 2017 to January 2019, in the Theodor Bilharz Research Institute.
Results
The mean±SD time for port site entry in transumbilical technique (group A) was 40.3±1.2 s compared with 131.9±5.5 s in the conventional infraumbilical and supraumbilical open techniques (group B), with significant difference between the groups, in favor of the transumbilical technique (group A) (<0.0001).
Conclusion
Transumbilical access for establishing pneumoperitoneum in laparoscopic cholecystectomy is considered as a fast, safe, effective, and simple technique with mild postoperative pain and less morbidity.

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