Minilaparoscopic Cholecystectomy - Half-Dome-Down Clipless Technique
4 years ago
Minilaparoscopic clipless cholecystectomy A cholecystectomy is performed using mini (3mm) instruments - only 10mm optics is used, no clips, cystic duct is ligated with knots and only electrocautery for the cystic artery. At the end gallbladder is removed inside a bag. Stigmatized as expensive and time consuming, minilaparoscopic cholecystectomy seemed to have no major advantages and did not progress the way industry had imagined. With various advancements in the MINI original technique, this procedure is now being performed with great result using a much simpler and more reliable NEW mini LowFriction reusable instruments. For an easier procedure, the problems of the MINI optics (expensive, fragile, bad image) were solved by simple not using it. Knots are tied to the cystic duct and the cystic artery is cautherized. This technique has been described in detail in a publication of 1000 cases (a series that now surpasses 2300), without mortality, conversion to open surgery or common bile duct injuries. In order to avoid the use of mini-scopes, gallbladders were removed in bags, and most of cases discharged in less than 24h with virtually no pain. In short cheaper is not necessarily worse, and recognized benefits were found in the NEW MINI technique which is a 1-day surgery, safe, with all the advantages of laparoscopy, highly reproducible, cost effective, and with great aesthetic appeal.