Minilaparoscopic Versus Conventional Laparoscopic Cholecystectomy: A Systematic Review and Meta-analysis

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Excerpt

The first reported laparoscopic cholecystectomy was performed in 1987 by Philip Mouret.1 Laparoscopic cholecystectomy is preferred to open cholecystectomy because of improved postoperative pain and perioperative morbidity.2 As a result, laparoscopic cholecystectomy is now the standard of care in performing cholecystectomy3 whereas open cholecystectomy is reserved only for the most complicated cases.3 Conventional laparoscopic cholecystectomy is performed using 4 incisions or ports; one 10–12-mm port in the umbilicus, one 5 mm- or 10–12-mm port in the subxiphoid region and two 5-mm ports in the right subcostal area of the abdomen.4 As laparoscopic techniques have advanced, cholecystectomy has been performed with smaller incisions and/or fewer ports, broadly referred to as minilaparoscopic surgery.5,6 Needlescopic surgery is a subcategory of minilaparoscopic surgery using the standard 4 incisions/ports and instruments that are less than or equal to 3 mm in diameter versus the 5-mm instruments that are used traditionally.7–9 Reduced trocar surgery is another subtype of minilaparoscopic surgery that uses less than 4 incisions to perform cholecystectomy. Other terms for minilaparoscopic surgery include miniport or microlaparoscopic surgery10,11; both these terms are used generally to indicate a laparoscopic procedure with smaller incision and/or fewer ports. More recently, single port access, cholecystectomy has been performed using a single trocar at the umbilicus.
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