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Consensus statement of the consortium for LESS cholecystectomy.

Publication ,  Journal Article
Ross, S; Rosemurgy, A; Albrink, M; Choung, E; Dapri, G; Gallagher, S; Hernandez, J; Horgan, S; Kelley, W; Kia, M; Marks, J; Martinez, J ...
Published in: Surg Endosc
October 2012

Many surgeons attempting Laparo-Endoscopic Single Site (LESS) cholecystectomy have found the operation difficult, which is inconsistent with our experience. This article is an attempt to promote a standardized approach that we feel surgeons with laparoscopic skills can perform safely and efficiently. This is a four-trocar approach consistent with the four incisions utilized in conventional laparoscopic cholecystectomy. After administration of general anesthesia, marcaine is injected at the umbilicus and a 12-mm vertical incision is made through the already existing anatomical scar of the umbilicus. A single four-trocar port is inserted. A 5-mm deflectable-tip laparoscope is placed through the trocar at the 8 o'clock position, a bariatric length rigid grasper is inserted through the trocar at the 4 o'clock position (to grasp the fundus), and a rigid bent grasper is placed through the 10-mm port (to grasp the infundibulum). This arrangement of the instruments promotes minimal internal and external instrument clashing with simultaneous optimization of the operative view. This orientation allows retraction of the gallbladder in a cephalad and lateral direction, development of a window between the gallbladder and the liver which promotes the "critical view" of the cystic duct and artery, and provides triangulation with excellent visualization of the operative field. The operation is concluded with diaphragmatic irrigation of marcaine solution to minimize postoperative pain. Standardization of LESS cholecystectomy will speed adoption, reduce intraoperative complications, and improve the efficiency and safety of the approach.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

October 2012

Volume

26

Issue

10

Start / End Page

2711 / 2716

Location

Germany

Related Subject Headings

  • Surgery
  • Humans
  • Cholecystectomy, Laparoscopic
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ross, S., Rosemurgy, A., Albrink, M., Choung, E., Dapri, G., Gallagher, S., … Zundel, N. (2012). Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc, 26(10), 2711–2716. https://doi.org/10.1007/s00464-012-2478-y
Ross, Sharona, Alexander Rosemurgy, Michael Albrink, Edward Choung, Giovanni Dapri, Scott Gallagher, Jonathan Hernandez, et al. “Consensus statement of the consortium for LESS cholecystectomy.Surg Endosc 26, no. 10 (October 2012): 2711–16. https://doi.org/10.1007/s00464-012-2478-y.
Ross S, Rosemurgy A, Albrink M, Choung E, Dapri G, Gallagher S, et al. Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc. 2012 Oct;26(10):2711–6.
Ross, Sharona, et al. “Consensus statement of the consortium for LESS cholecystectomy.Surg Endosc, vol. 26, no. 10, Oct. 2012, pp. 2711–16. Pubmed, doi:10.1007/s00464-012-2478-y.
Ross S, Rosemurgy A, Albrink M, Choung E, Dapri G, Gallagher S, Hernandez J, Horgan S, Kelley W, Kia M, Marks J, Martinez J, Mintz Y, Oleynikov D, Pryor A, Rattner D, Rivas H, Roberts K, Rubach E, Schwaitzberg S, Swanstrom L, Sweeney J, Wilson E, Zemon H, Zundel N. Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc. 2012 Oct;26(10):2711–2716.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

October 2012

Volume

26

Issue

10

Start / End Page

2711 / 2716

Location

Germany

Related Subject Headings

  • Surgery
  • Humans
  • Cholecystectomy, Laparoscopic
  • 3202 Clinical sciences
  • 1103 Clinical Sciences