Description and Initial Experience with the "LIFT" (Less Incisions but Four Trocars) Technique for Laparoscopic Cholecystectomy.

Abstract

Background: Modifications to conventional laparoscopic cholecystectomy (LC) aim to reduce trauma to the abdominal wall and improve cosmetic outcomes. Although single-incision laparoscopic surgery (SILS) provides excellent cosmetic results, the procedure is technically demanding. Herein, we describe the LIFT technique ("Less Incisions but Four Trocars"), with four trocars but only one 3-mm visible incision, using conventional instruments. Methods: Retrospective study with the LIFT technique for cholecystectomy during 2017. Access to the abdomen is obtained with two trocars (11 and 5 mm) through the same intraumbilical skin incision, and two extraumbilical 3-mm trocars for a correct triangulation (one of them concealed below the bikini line). The results are compared with a series of patients operated on with LC by the same surgical team during 2016. Results: During the study period, 90 procedures were performed. Both techniques showed similar results in terms of surgical time, conversion rate, complications, and hospital length of stay. The patients operated on with the LIFT technique reported better cosmetic evaluation and less postoperative pain at 3 months compared with LC. Conclusion: The LIFT technique is a safe and feasible alternative for cholecystectomy that can provide a significant improvement from the cosmetical point of view, mostly for those patients who are especially concerned with their body image.