Abstract

ORTIZ, Camilo; MUNOZ, Néstor; FLOREZ, Henry  and  SAAVEDRA, Silvio. Magnet assisted transvaginal hybrid approach cholecystectomy and magnet assisted single umbilical incision cholecystectomy. rev. colomb. cir. [online]. 2010, vol.25, n.2, pp.121-130. ISSN 2011-7582.

Introduction. Report of our initial experience with hybrid transvaginal cholecystectomy and with single incision transumbilical cholecystectomy in patients with the diagnosis of uncomplicated cholelithiasis using anchor magnetic device in both types of approach. Patients and methods. Prospective clinical case series. Patients were divided into two groups: Single Incision Transumbilical Laparoscopic Cholecystectomy (SILC) and Hybrid Transvaginal Cholecystectomy. An anchor magnetic device for intraoperative manipulation of the gallbladder was used in both groups. Operating time, length of hospital stay, complications, and postoperative course are reported. Results. A total of 23 patients were included, 10 by the hybrid transvaginal approach and 13 by the single incision umbilical approach. A magnetic retraction system was used for retraction, dissection and extraction of the gallbladder. Operating time was longer for the umbilical approach. There were no major complications. None of the patients registered abdominal or gynecological complaints, including discomfort at sexual intercourse. Conclusion. Both approaches are safe and comparable to the traditional technique at centers where laparoscopy is performed regularly. Although the umbilical approach registered shorter operating time, both types of procedure recorded acceptable operating times. The use of the magnetic device allows excellent exposure of Calot´s triangle and facilitates traction and retraction during the procedure. The good cosmetic result is evident for both approaches. Further prospective trials should be done in order to determine the clinical applicability of these two types of cholecystectomy.

Keywords : cholecystectomy; laparoscopic; vagina; video-assisted surgery; NOTES; SILC.