Mini-laparoscopy with fast-track protocols for the cholelithiasis and hernias treatment

Abstract

The aim —to analyze the first results of the mini‑laparoscopic cholecystectomy (in comparison with standard laparoscopic cholecystectomy), mini‑laparoscopic repair of hiatal hernia and Nissen fundoplication and mini‑laparoscopic transabdominal preperitoneal repair of inguinal hernia combined with the developed fast‑track protocols.Materials and methods. Mini‑laparoscopic cholecystectomy was performed in 11 female patients, mini‑laparoscopic Nissen fundoplication was performed in 3 female patients with gastroesophageal reflux disease associated with type I hiatal hernia, mini‑laparoscopic transabdominal preperitoneal repair was performed in 1 patient with inguinal hernia.Results and discussion. All mini‑laparoscopic cholecystectomies were performed successfully, without conversions, intra‑ and postoperative complications. The mean pain score next day after surgery was 2.6 points. The mean postoperative stay duration was 2.2 days. There were no intra‑ and postoperative complications after mini‑laparoscopic fundoplication. The mean pain score next day after surgery was 2.0 points. The mean postoperative stay duration was 2 days. There were no postoperative complications after mini‑laparoscopic transabdominal preperitoneal repair as well. The mean pain score next day after surgery was 2 points. Postoperative stay duration was 2 days.Conclusions. Mini‑laparoscopy can be successfully used for chronic calculous cholecystitis (and in some cases for acute cholecystitis), for small sliding hiatal hernias and GERD, and for inguinal hernias, with a good selection of patients and when they demand accelerated rehabilitation and cosmesis. Mini‑laparoscopy in combination with the developed fast‑track protocols reduces the length of hospital stay and the duration of early postoperative rehabilitation, reduce pain syndrome and improve cosmetic results.