Laparoscopic Cholecystectomy: Comparison of the American Technique vs the modified Technique in relation to Surgeon comfort

Abstract

Introduction: Surgeons reported exertion and musculoskeletal pain during or aer a procedure. Modifying the insertion of the trocar located in the clavicular midline to be placed in the midline, to improve the surgeon's posture. At the Hospital Universitario de Caracas, the modified laparoscopic cholecystectomy technique is frequently performed to reduce the sensation of effort and pain during the surgical act. The study of comfort elements for the surgeon with this modified technique is proposed. Methods: A prospective, descriptive, comparative and cross-sectional study was carried out in patients with gallbladder lithiasis at the Hospital Universitario de Caracas, from January to August 2022. Results: 77 laparoscopic cholecystectomies were performed, consisting of: American technique 32 (41, 6%) and the modified technique 45 (58.4%). The American technique showed the le wrist as a painful area (62.5%), and in the modified technique they reported no painful area in 91.1%. 43.8% of the surgeons did not feel comfortable with the American technique, while in the modified one 97.8% reported the comfortable technique. The surgeons reported a difficult effort in 56.3% with the American technique and with the modified one, 82.2% reported a light effort. e degree of pain in the extremities was greater in those who performed the American technique compared to the modified one, all of the results being statistically significant. Conclusion: The modified technique has advantages in terms of comfort for the surgeon and his team and can be used from the beginning of surgeon training.