A comparison study of left-hand three-port videoscopy, left-hand four-port videoscopy and standard four-port videoscopy in laparoscopic cholecystectomy

Abstract

AIM: Reviewing the recent publishments on the safeness and practicality of three-port cholecystectomy we aimed to introduce the results of cholecystectomy that were performed by the primary surgeon’s left hand videoscopy application through three ports.

MATERIAL AND METHODS: The data of 60 total laparoscopic cholecystectomy patients were retrospectively anaylsed. 20 patients underwent three-port laparoscopic cholecystectomy with videoscopy using the primary surgeon’s left hand, 20 patients underwent four-port laparoscopic cholecystectomy, again with left hand videoscopy application, and the other 20 patients underwent standard four-port laparoscopic cholecystectomy by a more experienced surgeon. Kolmogorov-Smirnov test was used to evaluate the distribution normalization of parameters. To compare the parameters of multiple groups; one-way ANOVA-Tukey HSD was used for normal distributed, the Kruskal-Wallis test was used for abnormal distributed values. Pearson’s chi-squared test was used for categorical values. The results with p-values of less than 0.05 were accepted as statistically significant.

RESULTS: There were no differences between the groups for preoperative (p=0.456) and perioperative clinical characteristics (p=0.918), mean operation time (p=0.855), perioperative complication (p=0.153), conversion to open surgery (p=0.362) and the need for first assistant surgeon (p=0.235). However, the need for second assistant surgeon (p=0.017), assistant nurse (p=0.014) and fourth tool usage (p=0.000) were significantly lower in the three port group.

CONCLUSION: Left-hand videoscopy in three-port laparoscopic cholecystectomy is reliable and effective as the conventional techniques and cheaper than conventional techniques. It’s easily applicaple and learnable for experienced surgeons.