A Modified Three-Port Laparoscopic Cholecystectomy: Shifting the Third Port to the Umbilicus

Abstract

Aim: The aim is to shift the 5 mm port from the right upper abdomen to the umbilicus in three-port laparoscopic cholecystectomy to obtain better cosmetic results. Methods: The three ports in conventional three-port laparoscopic cholecystectomy were placed in a 10 mm epigastric incision, a 5 mm umbilical incision and a 5 mm right upper abdominal incision. Our modified method involved movement of the 5 mm incision at the right upper abdomen to the umbilicus. The clinical data of 67 patients undergoing modified three-port laparoscopic cholecystectomy and 82 patients undergoing conventional three-port laparoscopic cholecystectomy in our hospital between February 2013 and April 2015 were collected, including operating time, intra-operative blood loss, need for conversion to open cholecystectomy, postoperative wound infection, length of hospital stay and satisfaction with cosmetic outcome. Results: One patient in the modified group and two in the conventional group were converted to open surgery due to celiac adhesion. There were no significant differences regarding operating time and blood loss between the two groups. Postoperative stay and wound infection were similar in the two groups, however, patients in the modified group were more satisfied with their cosmetic outcome (P = 0.0006). Conclusion: Movement of the 5 mm port from the right upper abdomen to the umbilicus in conventional laparoscopic cholecystectomy can be performed with acceptable operative outcomes and superior cosmetic results.