Optimization of the laparoscopic appendectomy
Aim - to improve short-term results of laparascopic surgical treatment in patients with chronic calculous cholecystitis. The study involved 23 patients with chronic calculous cholecystitis who were performed laparoscopic cholecystectomy. The technique of electric welding of biological tissues for treating the cystic duct and cystic artery was used. Laparoscopic cholecystectomy was standard. Preventive anesthesia was used before trocar intervention. The peritoneal space during surgical interventions was developed using laparolift techniques. After dissecting the bile cyst the cut gallbladder bed was welded ensuring reliable hemostasis. To prevent trocar hernias the bile cyst dissection was performed in the subxiphoid area at the site of trocar insertion. The use of laparolifts permits visualization of 360 degrees and free manipulating by treatment instruments. The mean operative time was 45±5 minutes. The abdominal drains were not performed. No fatal cases were reported. The average duration of hospitalization was 1,5±0,5 days. There were no postoperative intra-abdominal complications reported in the patients. The level of pain by the Visual Analogue Scale (VAS) was measured as 2,5±0,3 points (on the 10 - point scale), satisfaction with treatment outcomes was 4,6±0,2 points (on the 5-point scale). The patients did not receive antibacterial therapy. The suggested program is a safe therapeutic strategy that can be alternative to the standard methods of treatment and rehabilitation of patients with chronic calculous cholecystitis.