Minilaparoscopic cholecystectomy and Nissen fundoplication in combination with a fast track protocols in the Covid-19 pandemia environment

Keywords: biliary calculous disease; hiatal hernia; minilaparoscopy; pandemia for Covid-19; coronavirus.


Objective. Studying of the results of application of minilaparoscopic cholecystectomy and minilaparoscopic Nissen fundoplication in combination with protocols fast track in the Covid-19 pandemia environment.

Materials and metods. Minilaparoscopic cholecystectomy was conducted in 17 patients, minilaparoscopic Nissen fundoplication - in 8 patients.Results. For minilaparoscopic cholecystectomy were used one 10-mm, one 5-mm trocar and two 3-mm trocars for minigraspers. For minilaparoscopic fundoplication there were applied two 5-mm trocars and two 3-mm trocars for minigraspers, also 5-mm Nathanson’s retractor was installed without trocar. After mimilaparoscopic cholecystectomy the pain syndrome on the second day was estimated at average (1.3 ± 1.4) points (0 - 5 points), average duration of postoperative period have constituted (2.2 ± 0.4) bed-days (2 - 3 bed-days). After minilaparoscopic fundoplication the pain syndrome on the second day was estimated at average in (1.4 ± 1.4) points (0 - 3 points), average duration of postoperative period have constituted (2.7 ± 0.9) bed-days (2 - 4 bed-days).

Conclusion. Minilaparoscopic operations may be applied successfully in chronic calculous cholecystitis, small axial hiatal hernias and gastro-esophageal reflux disease. After minilaparoscopic operations in combination with elaborated protocol of fast track minimizes the pain syndrome and terms of the patients’ stationary stay, what is actual in the Covid-19 pandemia environment, and cosmetic result is improving as well. Further elaboration of the material for determination of role of these minilaparoscopic operations is needed.

Author Biographies

V. N. Zaporozhan, Odessa National Medical University

Zaporozhan Valery Mykolayovych, MD, DSci(Med), Professor,
Odessa National Medical University
Valyhovskyi lane, 2, 65082, Odessa, Ukraine
ORCID ID: 0000-0001-5288-3579

A. V. Malynovskyi, Odessa National Medical University

Malynovskyi Andrii Volodymyrovych, MD, DSci(Med), Professor,
Chair of Department of robotic and endoscopic surgery
Odessa National Medical University
22 Nischynskogo str., apt. 96, 65029, Odessa, Ukraine
ORCID ID: 0000-0003-4346-8933

M. M. Galimon, Odessa National Medical University

Galimon Mykhailo Mykhailovych, MD,
Assistant of Department of robotic and endoscopic surgery
Odessa National Medical University
1 Ispanskyi lane, apt. 20, 65031, Odessa, Ukraine
ORCID ID: 0000-0003-1551-6117


Udayasankar M, Udupi S, Shenoy A. Comparison of perioperative patient comfort with 'enhanced recovery after surgery (ERAS) approach' versus 'traditional approach' for elective laparoscopic cholecystectomy. Indian J Anaesth. 2020;64(4):316-21. doi: 10.4103/ija.IJA_782_19. Epub 2020 Mar 28. PMID: 32489207; PMCID: PMC7259410.

Pędziwiatr M, Mavrikis J, Witowski J, Adamos A, Major P, Nowakowski M, Budzyński A. Current status of enhanced recovery after surgery (ERAS) protocol in gastrointestinal surgery. Med Oncol. 2018;35(6):95. doi: 10.1007/s12032-018-1153-0. PMID: 29744679; PMCID: PMC5943369.

Schmidt J. Minilaparoskopie mit 5 mm-Optik und 3 mm-Trokaren [Minilaparoscopy with 5 mm optics and 3 mm trocars]. Chirurg. 2017;88(8):647-655. doi: 10.1007/s00104-017-0437-9. PMID: 28484787. [InGerman].

Alhashemi M, Almahroos M, Fiore JF Jr, Kaneva P, Gutierrez JM, Neville A, et al. Impact of miniport laparoscopic cholecystectomy versus standard port laparoscopic cholecystectomy on recovery of physical activity: a randomized trial. Surg Endosc. 2017;31(5):2299-309. doi: 10.1007/s00464-016-5232-z. Epub 2016 Sep 21. PMID: 27655375.

Dammaro C, Tranchart H, Gaillard M, Debelmas A, Ferretti S, Lainas P, et al. Routine mini-laparoscopic cholecystectomy: Outcome in 200 patients. J Visc Surg. 2017;154(2):73-7. doi: 10.1016/j.jviscsurg.2016.08.001. Epub 2016 Sep 9. PMID: 27618697.

Novitsky YW, Kercher KW, Czerniach DR, Kaban GK, Khera S, Gallagher-Dorval KA, et al. Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg. 2005;140(12):1178-83. doi: 10.1001/archsurg.140.12.1178. PMID: 16365239.

Malcher F, Cavazzola LT, Carvalho GL, Araujo GD, Silva JA, Rao P, et al. Minilaparoscopy For Inguinal Hernia Repair. JSLS. 2016 Oct-Dec;20(4):e2016.00066. doi: 10.4293/JSLS.2016.00066. PMID: 27777499; PMCID: PMC5055584.

Carvalho GL, Góes GHB, Cordeiro RN, Lima DL, Amorim LLL, Furtado RHM. A new hybrid mini-laparoscopic technique for Spigelian hernia. J Minim Access Surg. 2019;15(3):253-5. doi: 10.4103/jmas.JMAS_179_18. PMID: 30178771; PMCID: PMC6561054.

Santoro E, Agresta F, Aloisi P, Caravani A, Mancini R, Mulieri G, Ciardo LF, Bedin N, Mulieri M. Is minilaparoscopic inguinal hernia repair feasible? A preliminary experience. J Laparoendosc Adv Surg Tech A. 2005;15(3):294-7. doi: 10.1089/lap.2005.15.294. PMID: 15954832.

Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018. World J Surg. 2019;43(3):659-95. doi: 10.1007/s00268-018-4844-y. PMID: 30426190.

Vigneswaran Y, Prachand VN, Posner MC, Matthews JB, Hussain M. What Is the Appropriate Use of Laparoscopy over Open Procedures in the Current COVID-19 Climate? J Gastrointest Surg. 2020;24(7):1686-91. doi: 10.1007/s11605-020-04592-9. Epub 2020 Apr 13. PMID: 32285338; PMCID: PMC7153352.

Morris SN, Fader AN, Milad MP, Dionisi HJ. Understanding the "Scope" of the Problem: Why Laparoscopy Is Considered Safe during the COVID-19 Pandemic. J Minim Invasive Gynecol. 2020;27(4):789-91. doi: 10.1016/j.jmig.2020.04.002. Epub 2020 Apr 3. PMID: 32247882; PMCID: PMC7129473.

Veziant J, Bourdel N, Slim K. Risques de contamination virale des soignants au cours d’une laparoscopie pendant la pandémie de la Covid-19. J Chir Visc. 2020;157(3):S60-S63. doi: 10.1016/j.jchirv.2020.04.008. Epub 2020 Apr 21. PMID: 32322313; PMCID: PMC7172662. [In French].

Hoyuela C, Juvany M, Carvajal F. Single-incision laparoscopy versus standard laparoscopy for colorectal surgery: A systematic review and meta-analysis. Am J Surg. 2017;214(1):127-40. doi: 10.1016/j.amjsurg.2017.03.002. Epub 2017 Mar 14. PMID: 28343612.

Dimbarre D, de Loureiro PM, Claus C, Carvalho G, Trauczynski P, Elias F. Minilaparoscopic fundoplication: technical adaptations and initial experience. Arq Gastroenterol. 2012;49(3):223-6. doi: 10.1590/s0004-28032012000300011. PMID: 23011247.

How to Cite
Zaporozhan, V. N., Malynovskyi, A. V., & Galimon, M. M. (2020). Minilaparoscopic cholecystectomy and Nissen fundoplication in combination with a fast track protocols in the Covid-19 pandemia environment. Klinicheskaia Khirurgiia, 87(5-6), 3-8.
General Problems of Surgery