***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background : Two-port laparoscopic cholecystectomy has been reported to be safe and feasible . However , whether it offers any additional advantages remains controversial . This study reports a r and omized trial that compared the clinical outcomes of two-port laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy . Methods : One hundred and twenty consecutive patients who underwent elective laparoscopic cholecystectomy were r and omized to receive either the two-port or the four-port technique . All patients were blinded to the type of operation they underwent . Four surgical tapes were applied to st and ard four-port sites in both groups at the end of the operation . All dressings were kept intact until the first follow-up 1 week after surgery . Postoperative pain at the four sites was assessed on the first day after surgery using a 10-cm unscaled visual analog scale ( VAS ) . Other outcome measures included analgesia requirements , length and difficulty of the operation , postoperative stay , and patient satisfaction score on surgery and scars . Results : Demographic data were comparable for both groups . Patients in the two-port group had shorter mean operative time ( 54.6 ± 24.7 min vs 66.9 ± 33.1 min for the four-post group ; p = 0.03 ) and less pain at individual subcostal port sites [ mean score using 10-cm unscaled VAS : 1.5 vs 2.8 ( p = 0.01 ) at the midsubcostal port site and 1.3 vs 2.3 ( p = 0.02 ) at the lateral subcostal port site ] . Overall pain score , analgesia requirements , hospital stay , and patient satisfaction score on surgery and scars were similar between the two groups . Conclusion : Two-port laparoscopic cholecystectomy result ed in less individual port-site pain and similar clinical outcomes but fewer surgical scars compared to four-port laparoscopic cholecystectomy . Thus , it can be recommended as a routine procedure in elective laparoscopic cholecystectomy Advances in instrumentation have led to the development of 2-mm laparoscopic equipment . The purpose of our investigation was to vali date the safety and efficacy of laparoscopic cholecystectomy ( LC ) using one 10-mm and three 2-mm ports ( mini-LC ) . Mini-LC was performed using a 2-mm fiberoptic videolaparoscope inserted via a midepigastric port , 2-mm graspers inserted via right upper quadrant ports , and st and ard dissection , clipping , and cautery instruments inserted via the umbilical port .  Data from 100 sequential patients were acquired between July 1996 and August 1997 and compared with those of 100 sequential patients who had undergone conventional LC ( C-LC ) .  The operative time ranged from 30 to 256 minutes for the mini-LC group and 25 to 255 minutes for the C-LC group , with means of 89 and 82 minutes , respectively ( P > 0.05 ) . Postoperative length of stay ranged from 0 to 18 days for the mini-LC group and 0 to 21 days for the C-LC group , with means of 1.5 and 1.9 days , respectively ( P > 0.05 ) . There were no conversions to open cholecystectomy . These data suggest that a more minimalist approach to laparoscopic cholecystectomy can be accomplished safely and effectively The main objectives of minisite cholecystectomy ( MC ) are to have smaller incisions , better cosmetic results , less trauma , and a lower morbidity rate . This prospect i ve r and omized study compares MC with conventional laparoscopic cholecystectomy ( CLC ) in terms of surgical trauma and cosmetic results in 44 patients . Conversion from MC to CLC was required in five patients . No conversion to open surgery was needed in the CLC group . The average operating time was slightly longer in the MC group , but the difference was not statistically significant ( 81 minutes versus 72 minutes , p=0.22 ) . The population characteristics , postoperative respiratory function measurements , pain scores , and analgesic requirements were similar in the two groups . The average score for scar tissue was significantly lower in the MC group ( 0.73 versus 1.93 , p=0.0045 ) . Only the cosmetic results of MC were superior to CLC . This technique could be a feasible alternative procedure in patients seeking better cosmetic results . However , further studies with larger sample sizes are needed to evaluate the postoperative morbidity of MC.RésuméLes objectifs principaux de la cholécystectomie laparoscopique minime ( CM ) ( par mini-trocars ) sont de réaliser de plus petites incisions , d’obtenir un meilleur résultat esthétique , de provoquer moins de trauma et d’avoir un taux plus bas de morbidité que la cholécystectomie par laparoscopic classique . Cette étude prospect i ve r and omisée a comparé la CM à la cholécystectomie par laparoscopic ( CL ) traditionnelle en termes de traumatisme chirurgical et de résultat esthétique chez 44 patients . On a du convertir la CM en CL chez cinq patients . Aucune conversion vers la chirurgie ouverte n’a été nécessaire dans le groupe de CL traditionnelle . Le temps moyen d’intervention a été plus long dans le groupe CM mais cette différence n’était pas statistiquement significative ( 81 min vs. 72 min , p=0.22 ) . Les caractéristiques de la population , les fonctions respiratoires , les scores de la douleur et les besoins en analgésiques étaient similaires dans les deux groupes . Les scores moyens d’évaluation de la cicatrice ont été significativement plus bas dans le groupe CM ( 0.73 vs. 1.93 , p=0.0045 ) . Seuls les résultats esthétiques de la CM étaient supérieurs à la CL . Cette technique pourrait être une alternative valable chez les patients cherchant une amélioration des résultats esthétiques . Cependant , d’autres études avec des échantillons plus larges sont nécessaires pour évaluer la morbidité postopératoire de la CM.ResumenEl propósito principal de la colecistectomía de invasión mínima ( CIM ) es lograr una cicatriz pequeña , mejor apariencia estética , menos trauma y morbilidad reducida . El présente estudio prospect i ve y aleatorizado compara la CIM con la colecistectomía laparoscópica convencional ( CLC ) en cuanto a trauma operatorio y result ado estético en 44 pacientes . Se requirió conversión de CIM a CLC en cinco pacientes , pero ninguna CLC tuvo que ser convertida a cirugía abierta . El promedio del tiempo operatorio fue ligeramente más prolongado en la CIM , pero la diferencia no es estadísticamente significativa ( 81 min versus 72 min , p=0.22 ) . Las características demográficas de los dos grupos eran similares y las determinaciones postoperatorias de función respiratoria , grado de dolor y requerimiento analgésico fueron sensiblemente iguales . El grado de tejido cicatricial fue significatamente menor en el grupo de la CIM ( 0.73 versus 1.93 , p=0.0045 ) . Sólo el result ado estético de la CIM fue superior al de la CLC . Esta técnica podría ser una alternativa factible en pacientes que busquen un mejor result ado estético . Sin embargo , se requieren estudios adicionales y grupos de pacientes más numerosos para evaluar la morbilidad postoperatoria de la CIM BACKGROUND Downsizing the port incisions may reduce pain after laparoscopic cholecystectomy . METHODS In a double-blind controlled study , 60 patients were r and omized to undergo either microlaparoscopic cholecystectomy using one 10-mm and three 3.5-mm trocars ( 3.5-mm LC ) or traditional laparoscopic cholecystectomy using two 10-mm and two 5-mm trocars ( LC ) .  Incisional pain at each port incision and overall pain were recorded for 1 week after the operation . Fatigue , nausea and vomiting , pulmonary function , and cosmetic results were also measured . RESULTS Data from 52 patients were analyzed ; eight patients were excluded from the study for various reasons . One patient was converted from 3.5-mm LC to LC due to technical problems with the 3.5-mm optic . In the 3.5-mm LC group ( n = 25 ) , incisional pain was significantly decreased in the 1st postoperative week as compared with the LC group ( n = 27 ) ( p < 0.01 ) . In both groups , pain scores at the supraumbilical 10-mm port were significantly higher compared with other port sites ( p < 0.05 ) . The cosmetic results were significantly better in the 3.5-mm LC group ( p < 0.01 ) . There were no significant differences in any of the other variables . CONCLUSION The use of 3.5-mm trocars is feasible in LC , and it both reduces incisional pain and improves the cosmetic result Laparoscopic cholecystectomy has rapidly become established as the treatment of choice for cholecystolithiasis . There is very little evidence , however , to support the cl aim ed benefit to patients . In the present study 30 consecutive patients below the age of 65 years without acute cholecystitis and with no signs of common bile duct stones were r and omized to laparoscopic or conventional open eholecystectomy .  Median ( interquartile range ) intravenous consumption of pethidine with a patientcontrolled injection device between 13 and 24 h after surgery was 125 ( 62–175 ) mg in patients who underwent the laparoscopic procedure and 200 ( 150–250 ) mg in those who had open operation . Urinary adrenaline and cortisol levels as well as those of plasma glucose , C‐reactive protein and interleukin 6 were increased after surgery in both groups of patients , but without any significant difference between them . The mean(s.d . ) duration of postoperative hospital stay ( 2·8(0·8 ) versus 1·8(0·6 ) days ) and sick leave ( 24·0(4·4 ) versus 11·7(4·1 ) days ) was significantly longer with open than laparoscopic cholecystectomy . The findings demonstrate obvious advantages of laparoscopic surgery  as regards postoperative pain and convalescence , although factors reflecting the magnitude of trauma did not differ Objectives : With increasing surgeon experience , laparoscopic cholecystectomy has undergone many refinements including reduction in port number and size . Three-port laparoscopic cholecystectomy has been reported to be safe and feasible in various clinical trials . However , whether it offers any additional advantages remains controversial . This study reports a r and omized trial that compared the clinical outcomes of 3-port laparoscopic cholecystectomy versus conventional 4-port laparoscopic cholecystectomy . Methods : Seventy-five consecutive patients who underwent elective laparoscopic cholecystectomy were r and omized to undergo either the 3-port or the 4-port technique . Four surgical tapes were applied to st and ard 4-port sites in both groups at the end of the operation . All dressings were kept intact until the first follow-up 1 week after surgery . Postoperative pain at the 4 sites was assessed on the first day after surgery by using a 10-cm unscaled visual analog scale ( VAS ) . Other outcome measures included analgesia requirements , length of the operation , postoperative stay , and patient satisfaction score on surgery and scars . Results : Demographic data were comparable for both groups . Patients in the 3-port group had shorter mean operative time ( 47.3±29.8 min vs 60.8±32.3 min ) for the 4-port group ( P=0.04 ) and less pain at port sites ( mean score using 10-cm unscaled VAS : 2.19±1.06 vs 2.91±1.20 ( P=0.02 ) . Overall pain score , analgesia requirements , hospital stay , and patient satisfaction score ( mean score using 10-cm unscaled VAS : 8.2±1.7 vs 7.8±1.7 , P=0.24 ) on surgery and scars were similar between the 2 groups . Conclusion : Three-port laparoscopic cholecystectomy result ed in less individual port-site pain and similar clinical outcomes with fewer surgical scars and without any increased risk of bile duct injury compared with 4-port laparoscopic cholecystectomy . Thus , it can be recommended as a safe alternative procedure in elective laparoscopic cholecystectomy The outcomes after traditional laparoscopic cholecystectomy ( LC ; one 10‐mm port , one 12‐mm port and two 5‐mm ports ) and minilaparoscopic cholecystectomy ( MLC ; three 3‐mm ports and one 12‐mm port ) for gallstone disease were compared BACKGROUND Needlescopic cholecystectomy ( NC ) utilises instruments and ports smaller than 3 mm in diameter compared with the 5 mm ones used in conventional laparoscopic cholecystectomy ( LC ) . Post-operative pain control and recovery has been thought to be superior in NC , when compared with historical controls with LC , but has not been proven in a prospect i ve fashion . PATIENTS AND METHODS A prospect i ve r and omised trial of NC versus 
    Output:
    
Although minilaparoscopic surgeries were converted , more often there was not a trend toward increased conversion to an open technique .