Minilap In The Application Of Transumbilical Laparoscopic Cholecystectomy

Background: at present, one of the hot research scholars and experts in the field of global minimally invasive surgery is the natural orifice transluminal endoscopic surgery(NOTES). In our hospital from 2010 it gradually began to explore the natural orifice transluminal surgery(NOTES) surgery, is also aware of the operation is still in the experimental stage, from the clinical work there is a certain distance from the 1-2. At present, the application of transumbilical endoscopic operation(Transumbilical endoscopic, surgery, TUES) is "the highest possibility of body surface skin scar" technology, is regarded as the transitional stage of the NOTES operation. The TUES operation is not only a kind of safe, effective, feasible operation mode, and also has a good cosmetic effect, less pain, rapid recovery and other potential advantages(3). However, the TUES operation also encountered many problems, such as surgical instruments and laparoscopic coaxial(chopsticks effect between laparoscopic lens), and surgical instruments, surgical instruments during operation frequent collision and interference. At the same time, such a problem exists in the course of operation, without operation triangulation in operation, so that mechanical ergonomics design principles which allows the surgeon fatigue. In the initial stage, due to the presence of surgical skills shortage and lack of experience, naturally led to relatively prolonged operative time, and increase the risk of surgery, anesthesia. Because of the existence of the above difficulties and shortcomings, which limit its use of the breadth and depth of. At present, although it has invented various operation devices can be bent, but in clinical practice is still inadequate. The recent introduction of a new mini grab grab--Minilap, which has been used in the TUES operation, aims to reduce the difficulty of operation. The research group, to explore the significance of Minilap in the safety, feasibility and operation techniques of transumbilical laparoscopic cholecystectomy by Minilap assisted transumbilical and transumbilical laparoscopic cholecystectomy clinical comparative study.Objective: the Minilap assisted transumbilical and transumbilical laparoscopic cholecystectomy of comparative analysis, to explore the advantages and disadvantages of transumbilical laparoscopic cholecystectomy assisted by Minilap.Methods: retrospective analysis of our hospital from 2014 March-2015 year in January during the 20 cases of Minilap assisted transumbilical and at the same time with matching transumbilical laparoscopic cholecystectomy(20 cases) of the medical records. Comparison between the two groups in the operation time, intraoperative blood loss, complications, hospitalization time and cost, intestinal function recovery time, abdominal wall cosmetic effect score, pain score(incision), nausea and vomiting rating(24 hours), the difference of weak points, trauma index.Results: the two groups in the intestinal function recovery time, bleeding volume, length of postoperative nausea and vomiting rating(24 hours), the hospitalization time and costs, weak points, complications, incision pain, abdominal trauma index score of beauty, there was no significant difference(P >0.05), Minilap assisted transumbilical the way of laparoscopic cholecystectomy group(group A) operation time consumed for short, is obviously better than that of transumbilical laparoscopic cholecystectomy group(P<0.001), after 2 weeks, two groups of patients were no obvious scar. Conclusion: compared with transumbilical laparoscopic cholecystectomy, Minilap assisted transumbilical laparoscopic cholecystectomy with intraoperative bleeding volume, postoperative recovery and better cosmetic result at the same time, also has the advantages of short learning curve, short operation time, operation difficulty is low. Minilap assisted transumbilical laparoscopic cholecystectomy can be achieved with transumbilical laparoscopic cholecystectomy in the same therapeutic effect, and is safe, feasible and effective, more important is to have cosmetic effect, less pain, rapid recovery and other potential advantages, reduce the operation difficulty of transumbilical laparoscopic cholecystectomy the majority of patients, and has been unanimously approved.