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Scarless umbilical camera port incision in laparoscopic cholecystectomy

Author: 
Dr. Md. Asjad Karim Bakhteyar, Dr. Binod Kumar, Dr. Pranay Kumar, Dr. Sushil Kumar, Dr. Shakil Jawed, Dr. Habibullah Ansari and Dr. Kumar Abhishek Ranjan
Subject Area: 
Health Sciences
Abstract: 

Background: Cholecystitis is one the most common disease encountered to general surgeons or G I surgeons in Bihar. Laparoscopic cholecystectomy is the standard treatment of choice in cases of acute/chronic cholecystitis, cholelithiasis, empyema, pyocele, gall bladder polyp etc. Cholecystectomy used to be done early in Bihar region because of high risk of carcinomatous transformation. As the time passes scar less surgery is getting more and more acceptance among surgeons and patients both. Advancement in laparoscopic surgery is very fast in recent years. 1st laparoscopic cholecystectomy was performed on September 12, 1985. Then advances to Single incision laparoscopic cholecystectomy (SILC) and Natural orifice trans-luminal endoscopic surgery (NOTES).With conventional multiport laparoscopic cholecystectomy (MPLC) most of the surgeons feel comfortable as compared to SILC. Our study was conducted on various complications of umbilical camera port incision in laparoscopic cholecystectomy, but main concern was cosmetic out come. Materials and Methods: This study was conducted on 92 patient underwent laparoscopic cholecystectomy by a single surgeon ranging from age group 14-70 years. Study was conducted between July 2016 to February 2017. All the patients were prior informed about the study and written consent were taken. All patients underwent multiport laparoscopic cholecystectomy and camera port was created through umbilicus (intra-umbilical camera port incision). Patients were followed for 6 months for complications in camera port like, port site hernia, port site infection scar and intra-operative port site bleed. Results: Out of 92 patients studied male were 21.7% and rest were females. Youngest patient was a 14 year female and oldest one was also a female of 70 years. Most common age group affected were in between 20-40 years, 65.2% patients lies in this group. All patients underwent conventional four port laparoscopic cholecystectomy with umbilical camera port incision. Some of the complications of umbilical port were studied, finding about visible scar, port site incisional hernia and intra-operative port site bleed were good. Visible scar and hernia were in 0% patient, intra-operative bleed were seen in 3.3% patients. Port site infections were observed in 5.4% patients. Conclusion: In umbilical port incision scar were not visible, neither port site hernia is seen. Port site infection is not too much (5.4%) and intra-operative bleed is also very less (3.3%), in near future umbilical port is going to replace peri-umbilical port incision mainly because of its cosmetic outcome.

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