Scarless Cholecystectomy with Standard Laparoscopic Instruments in Selected Patients

Abstract

Laparoscopic cholecystectomy is a gold standard for treatment of gallstone-related diseases. We have now modified this technique and introduced scarless cholecystectomy with standard laparoscopic instruments. Patients with normal body mass index and with no previous history of acute cholecystitis are suitable candidates for scarless cholecystectomy. Operation is performed through two 10 mm ports placed just above and below the umbilicus. Surgical exposure is created by applying two traction sutures, one placed in fundus and another in infundibulum of gallbladder. The ends of these sutures are pulled out the abdomen by means of percutaneously inserted suture passer. Applying different traction to these stitches, enable appropriate exposure of the Calot’s triangle and gallbladder bed for dissection. We have concluded that scarless cholecystectomy is technically feasible and safe. Further validation of this approach, however, awaits randomized clinical trials and accurate comparison with outcomes of more conventional approaches.