Medical Health Encyclopedia

Mini-Laparotomy Cholecystectomy. Mini-laparotomy cholecystectomy uses small abdominal incisions but, unlike laparoscopy, it is an "open" procedure and the surgeon does not operate through a scope. The surgical instruments used are very fine caliber (2 to 3 mm in diameter, or about a tenth of an inch). Eventually this technique may reduce operative time and improve results compared to laparoscopy.

Needlescopic Cholecystectomy. Procedures that use even fewer and smaller incisions than laparoscopy are being developed. There are many variations, including those referred to as twin-port, mini-site, or mini- or micro-laparoscopic surgeries. These procedures make even fewer incisions (two to three) and smaller ones (1.2 to 3 mm, or less than a tenth of an inch). It should be noted, however, that these procedures still require one large incision (10 to 12 mm, or about half an inch). They are still investigative and have some disadvantages:

• Fiberoptics, used to view the surgical areas, do not provide light that is as bright as light in conventional laparoscopy.
• The instruments are very fragile.
• The field of vision is very limited.

Although experience is very limited, studies are showing promise for reducing postoperative pain and improving recovery time beyond that of standard laparoscopy.

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Telerobotic Surgery. In one high-tech experiment, a woman in Stasbourg, France had her gallbladder successfully removed by surgeons in New York using laparoscopy controlled by a remote robotic device. The procedure took 54 minutes and was free of complications.