Objectives The “marionette technique” for transumbilical laparoscopic cholecystectomy (m-TLC) offers improved cosmesis and possibly shorter postoperative recovery for patient undergoing laparoscopic cholecystectomy versus the four-port conventional laparoscopic cholecystectomy (CLC). We compared the outcomes of m-TLC and CLC at a tertiary care facility in New York.

Methods A retrospective chart review was conducted and data on patients who underwent m-TLC and CLC were retrieved. Hospital length of stay (LOS), operative time, and complications were compared between the two groups using linear and logistic regression, as appropriate.

Results M-TLC group patients were significantly younger, predominantly females with lower body mass index. They were less likely to have previous abdominal surgery and more likely to have noninflammatory pathology (p < 0.05 for all). Nonadjusted LOS (1 vs. 3 days, p-value < 0.0001) and operative time (50 vs. 56 minutes, p-value = 0.007) were significantly lower among patients who underwent m-TLC; however, there was no significant difference on multivariate analysis. In multivariate analysis, there was no difference in the overall complication rate (odds ratio: 1.63; 95% confidence interval 0.02–2.39).

Conclusion With careful patient selection, m-TLC offers better cosmesis with comparable safety outcomes.

Level of evidence Level III.

A.H.S., J.S., H.H., M.K.G., and H.A. participated in drafting the manuscript. A.H.S. and H.A. were involved in acquisition, analysis, and interpretation of data. D.S. participated in study concept and design, and supervised the project.

Received: 19 July 2022

Accepted: 04 November 2022

Article published online:
10 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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