Feasibility of the Conventional Laparoscopic Set-up in Trans Umbilical Cholecystectomy in Low Economic Country

to achieve better cosmetic results. Trans umbilical cholecystectomy (TUC) gained popularity but with associated
challenging ergonomic and higher cost due to the need of specialized access platform and instruments (SAPI). This
has led to limiting their widespread especially in low economic countries. We aimed here to study the feasibility
and safety of using the conventional laparoscopic set-up in performing trans umbilical cholecystectomy (TUC) in
our tertiary care university hospital.
Patients and methods: We conducted a prospective cohort study, from January 2016 to June 2018, eligible
patients with symptomatic gall stones (100 cases) were divided into two groups: group A, TUC with conventional
instruments (TUC-CI) versus group B, TUC with specialized instruments (TUC-SI). Exclusion criteria were acute
cholecystitis, biliary pancreatitis, choledocholithiasis, BMI ≥ 35, previous upper abdominal surgeries, pregnancy,
and ASA score higher than 2. Demographic data, perioperative complications, conversion rate, hospital stay, and
procedure cost were recorded and statistically compared between the groups.
Results: There was sample homogeneity between both groups regarding age, sex, and BMI. No significant
difference (P -Value ≥0.05) between both groups regarding the mean operative time (48± 23.50, 45.5 ± 19.11),
hospital stay (0.4 ± 1.06 vs 0.32 ± 0.84) respectively, postoperative complications, and conversion rate to CLC. No
major intraoperative complications or conversion to open surgery were needed in both groups. The cost of TUC-SI
was significantly higher due to the cost of SAPI.
Conclusions: Trans umbilical single incision laparoscopic cholecystectomy is feasible with the same set-up used
in conventional laparoscopic cholecystectomy in selected patients without any additional cost of specialized access
platform & instruments. CLC is still our primary procedure.