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

Abstract

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.

Keywords

• biliary calculous disease; hiatal hernia; minilaparoscopy; pandemia for covid-19; coronavirus.