Basic Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2016; 22(13): 3558-3563
Published online Apr 7, 2016. doi: 10.3748/wjg.v22.i13.3558
Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port
Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Takashi Nagase, Tsutomu Masaki
Hirohito Mori, Nobuya Kobayashi, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Taiga Chiyo, Maki Ayaki, Tsutomu Masaki, Department of Gastroenterology and Neurology, Kagawa University, Kita, Kagawa 761-0793, Japan
Hirohito Mori, Takashi Nagase, Department of Gastroenterological Surgery, Ehime Rosai Hospital, Niihama, Ehime 792-8550, Japan
Author contributions: Mori H was responsible for conceiving the research and drafting the article; Kobayashi N, Kobara H, Nishiyama N, Fujihara S, Chiyo T, Ayaki M, Nagase T participated equally in the work; Masaki T provided a critical revision of the manuscript for intellectual content and was responsible for the final approval of the manuscript.
Institutional animal care and use committee statement: Animal experiments were performed in the Preclinical Animal Laboratory of Kagawa University, Japan. All experimental procedures were performed according to the guidelines for the care and use of animals as established by Kagawa University, Japan.
Conflict-of-interest statement: To the best of our knowledge, no conflict of interest exists.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hirohito Mori, MD, PhD, Department of Gastroenterology and Neurology, Kagawa University, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793, Japan. hiro4884@med.kagawa-u.ac.jp
Telephone: +81-87-8912156 Fax: +81-87-8912158
Received: October 11, 2015
Peer-review started: October 12, 2015
First decision: November 5, 2015
Revised: November 9, 2015
Accepted: December 14, 2015
Article in press: December 14, 2015
Published online: April 7, 2016
Abstract

AIM: To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or not.

METHODS: Two dogs (11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port.

RESULTS: The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one port.

CONCLUSION: We are sure of great feasibility of endoscopic cholecystectomy via single port for human.

Keywords: Laparoscopic and endoscopic cooperative surgery, Endoscopic cholecystectomy, Single port, Safer and complete resection, Feasibility

Core tip: Endoscopic cholecystectomy via single port is a safety and reliable new flexible endoscopic surgery. Local injection of saline to the gallbladder bed makes it easier to resect the gallbladder bed from the liver. After complete dissection of the gallbladder bed, the neck of the gallbladder was clipped and cut safer and easier using ring-shaped thread method.