Combination of Cholecystectomy and Salpingooophorectomy in Keyless Abdominal Rope-lifting Surgical Technique

Turgut Anuk, MD, Kahraman Ülker, MD, Barlas Sülü, MD, Ürfettin Hüseyı̇noğlu, MDDepartment of General Surgery, Kafkas University School of Medicine, Kars, Turkey (Drs. Anuk and Sülü).Department of Obstetrics and Gynecology, Kafkas University School of Medicine, Kars, Turkey (Dr. Ülker).Department of Anesthesia and Reanimation, Kafkas University School of Medicine, Kars, Turkey (Dr. Hüseyı̇noğlu).

ABSTRACT 

Introduction: During keyless abdominal rope-lifting surgery (KARS) the intra-abdominal operations are performed through the single intra-umbilical incision following the lifting of the abdominal wall by sutures loaded in the Veress cannula without using CO2 and trocars. However, it is unclear whether KARS is suitable for the combination of two different surgical procedures performed in the lower and upper abdominal viscera. In this paper we aimed to present the first case of the combination of cholecystectomy and salpingooophorectomy performed by using the KARS technique.Case Report: A sixty-seven year old, gravidity 7, parity 7, postmenopausal woman was referred to our center with the symptoms of nausea, vomiting and right upper abdominal pain. Physical examination was not remarkable other than a mild right upper abdominal tenderness and a positive Murphy sign. Ultrasound examination revealed a hydropic gall bladder with micro calculi and the bile duct was dilated with a width of 11–12 mm and there was an image compiled with bile sludge located distal to the dilatation area. In addition, there was a septated cyst with 95x65x46 mm diameters in the left adnexal region. Cholecystectomy and salpingoophorectomy were performed through the same single incision of KARS. The woman was discharged at the 2nd postoperative day.

Conclusion: To our knowledge, this is the first case report presenting the operative management of a gall-bladder disease and adnexal cyst by using a single incision and gasless minimal invasive surgical technique. KARS seems feasible for the combination of cholecystectomy and salpingoophorectomy.

Key Words: Cholecystectomy, Minimally invasive, Ovariectomy, Salpingectomy, Surgical procedures.

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