9382GS Laparo-Endoscopic Single Site (LESS) Cholecysto-Hysterectomy
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Uploaded by SocietyLapSurgeons on Jul 23, 2009
TITLE: Laparo-Endoscopic Single Site (LESS) Cholecysto-Hysterectomy
Introduction: Laparo-Endoscopic Single Site (LESS) surgery completes the evolutionary arc from open to laparoscopic to no scar surgery. Improvements in LESS surgical technique and instrumentation will expand the spectrum of operations attainable by LESS surgery. This video demonstrates concomitant LESS cholecystectomy and hysterectomy in a 37-year-old female with symptomatic biliary colic and fibroid
uterus.
Methods: The operations were undertaken through a single 12-mm incision at the umbilicus utilizing a multi-port trocar containing three 5-mm ports. A 5-mm deflectable tip laparoscope was utilized for visualization. The gallbladder was retracted with a grasper, and the critical view was easily obtained with the deflectable tip laparoscope. Both the cystic duct and artery were clipped and divided, and the gallbladder was dissected free from the liver bed with the aid of a hook cautery. The gallbladder was placed into an endo-catch bag. Attention was then directed to the pelvis where the
uterus was dissected utilizing a grasper and an articulating Thermaseal device. Both the uterus and the gallbladder were extracted through the vagina. The vagina was repaired laparoscopically with interrupted sutures.
Results: The patient tolerated the operation well and had an uneventful postoperative hospital course. She was discharged home 18 hours postoperatively and is expected to immediately resume a normal lifestyle.
Conclusions: LESS cholecystectomy and hysterectomy offers improved patient cosmesis and less body image distortion, while shortening recovery time to normal activity. LESS surgery will be embraced by patients, and laparoscopic surgeons will need to meet patients demands.
Abs# 9382GS
Authors: Sharona Ross, MD, Stuart Hart, MD, Kellie McFarlin, MD, Connor Morton, BS, Alexander Rosemurgy, MD
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