Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study

Hoyuela, Carlos; Juvany, Montserrat; Guillaumes, Salvador; Ardid, Jordi; Trias, M.; Bachero, Irene; Martrat, Antoni

doi:10.1007/s10029-019-01969-x

Cited by 30 publications

(17 citation statements)

References 42 publications

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“…Reported of umbilical hernia after single-port surgery range from 2.4% to 13.3%, [15][16][17][18] and in a recent study, it was shown that the incidence of incisional hernia at the umbilical post site after long-term followup was greater for SILC than standard three-port cholecystectomy. 18 In addition, obesity, old age, and preexisting umbilical hernia were reported to predict postoperative incisional hernia after single-port surgery. However, no study has yet addressed the incidence of postoperative incisional hernia in patients treated by SILC for acute cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

The First Additional Port During Single-Incision Laparoscopic Cholecystectomy

Kim

2020

JSLS

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Background and Objectives: Single-incision laparoscopic cholecystectomy (SILC) has become increasingly popular. Regarding the difficulties of SILC in acute cholecystitis, additional port insertion is sometimes required. However, appropriate locations for additional port insertion have not been well studied. In the present study, the safety and effectiveness of the first additional port insertion in the epigastric region during SILC was assessed.Methods: Additional port insertions were needed in 52 of 113 patients who underwent SILC for acute cholecystitis. The first port was inserted in the epigastric region and the second (if required) was inserted in the right lateral subcostal area. A drainage catheter was positioned through the epigastric port.Results: One additional port was inserted in 43 patients and two additional ports were inserted in 9 patients. Mean operation time was 45.0 minutes in the Pure SILC group and 83.3 minutes in Additional Port group. Mean hospital stay was 3.7 days in the Pure SILC group and 5.9 days in Additional Port group. There was no open conversion. Intra-operative (n ϭ 5) and postoperative bile leakages (n ϭ 2) were identified in six patients. Timing of operation after onset of symptoms was significantly greater in the group with bile duct injury than in those without bile duct injury in patients who required additional ports. Conclusions:The first additional port in the epigastric area during SILC for acute cholecystitis helps to complete the operation without open conversion. However, the procedure can be performed safely in selective patients with relatively short duration of symptoms.

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Section: Discussionmentioning

confidence: 99%

The First Additional Port During Single-Incision Laparoscopic Cholecystectomy

Kim

2020

JSLS

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“…Minimally invasive surgery for gallbladder disease has advantages of less pain, smaller scars, shorter length of hospital stay and quicker return to normal activities, which has become increasingly popular in patients (Bignell et al 2013;Bisgaard et al 2002;Sinagra et al 2018). Although several studies have revealed the e cacy of SILC, its increased risks of pain, bile duct injury and port-site hernia formation with a larger umbilical incision and prolonged operative time, and the need for specialty ports and instruments have raised con icting concerns (Arezzo et al 2018;Hoyuela et al 2019;Lee et al 2019;Lim et al 2017). In this study, a TILC technique was described that only needs conventional instruments.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy with two mini incisions: an innovative, feasible and safe technique with superior cosmetic outcomes

Xu¹,

Wang²,

Fang³

et al. 2020

Preprint

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The conventional laparoscopic cholecystectomy (CLC) is usually performed with four incisions in a simple and safe way. Minimally invasive surgery for gallbladder disease with advantages of less pain and smaller scars, has become increasingly popular in patients. This study aimed to describe our experience in performing a new technique of two-incision laparoscopic cholecystectomy (TILC) with conventional instruments and make a comparison with CLC. In this study, forty-three prospective patients undergoing TILC and another forty-three historical cases operated by CLC were involved. The patients were examined in respect of operative time, postoperative pain, cosmesis and complications. We found that there was no significant difference in the gender, age, body mass index, bile duct damage, blood loss and days of postoperative hospital stay between TILC and CLC. The mean operation time in TILC was longer than that in CLC, but not statistically different. Significantly lower postoperative pain scores were reported in the TILC group than those in the CLC one (p = 0.019). The mean cosmetic satisfaction score was significantly higher in TILC group than that in CLC group (p < 0.05). These results confirm that TILC is a safe and feasible technique with less postoperative pain and a significant improvement in cosmesis for patients, only by using conventional instruments. It may be a good alternative to CLC in the future.

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“…These procedures also require special instruments. [21][22][23][24] In this report, we presented a new TILC procedure that can be performed with conventional instruments. All patients were operated based on a 5-mm laparoscope, which was placed in the umbilical incision and which provided a visual field and images exactly as for CLC.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy with two incisions: an improved, feasible and safe technique with superior cosmetic outcomes

Wang

Dai

et al. 2020

J Int Med Res

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Objective Conventional laparoscopic cholecystectomy (CLC) is usually performed with four incisions. Minimally invasive surgery for gallbladder disease with less pain and smaller scars has become increasingly popular. This study reported a new, two-incision laparoscopic cholecystectomy (TILC) using conventional instruments. Methods In this prospective study, 43 patients were recruited to undergo TILC and were compared with 43 historical cases undergoing CLC. We evaluated operative time, postoperative pain, cosmesis and complications. Results There was no significant difference in gender, age, body mass index, bile duct damage, blood loss and postoperative hospital stay between the two groups. The mean operation time was longer with TILC than with CLC, but the difference was not statistically different. Postoperative pain scores were significantly lower with TILC than with CLC. The mean cosmetic satisfaction score was significantly higher with TILC than that with CLC. There was no significant difference in the incidence of complications between the two groups. Conclusion Our work demonstrates that TILC generates less postoperative pain and significantly improved cosmesis for patients. TILC is a safe and feasible alternative to CLC.

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Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study

Cited by 30 publications

References 42 publications

The First Additional Port During Single-Incision Laparoscopic Cholecystectomy

The First Additional Port During Single-Incision Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy with two mini incisions: an innovative, feasible and safe technique with superior cosmetic outcomes

Laparoscopic cholecystectomy with two incisions: an improved, feasible and safe technique with superior cosmetic outcomes

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