One-wound laparoscopic cholecystectomy

Navarra, Giuseppe; Pozza, E; Occhionorelli, Savino; Carcoforo, Paolo; Donini, I.

doi:10.1046/j.1365-2168.1997.02586.x

Cited by 371 publications

(205 citation statements)

References 2 publications

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“…In all cases, except one [16], at least one transparietal access was necessary to perform the cholecystectomy [13][14][15][16]. In this regard, umbilical SPA cholecystectomy is not more invasive than NOTES because it does not involve an additional translumenal access [28,29].…”

Section: Discussionmentioning

confidence: 99%

Single Port Access Laparoscopic Cholecystectomy (with video)

et al. 2008

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Background Single port access (SPA) surgery is a rapidly evolving field due to the complexity of NOTES (natural orifice translumenal endoscopic surgery). SPA combines the cosmetic advantage of NOTES and possibility to perform surgical procedure with standard laparoscopic instruments. We report a technique of umbilical SPA cholecystectomy using standard laparoscopic instruments and complying with conventional surgical principle and technique of minimally invasive cholecystectomy. Methods Preliminary, prospective experience of SPA cholecystectomy in 11 patients (median age, 46 (range, 27-63) years) scheduled for cholecystectomy was evaluated. Diagnoses for cholecystectomy were: symptomatic gallbladder lithiasis (n = 7), previous acute cholecystitis (n = 3), and biliary pancreatitis (n = 1). Results SPA cholecystectomy was feasible in all patients (median body mass index, 24 (range, 20-34) kg/m 2 ) who were scheduled for preliminary experience using conventional laparoscopic instruments. Median operative time was 52 (range, 40-77) minutes. Intraoperative cholangiography was performed in all patients, except one, and was considered normal. No peroperative or postoperative complications were recorded. Median hospital stay was less than 24 h.Conclusions SPA cholecystectomy is feasible and seems to be safe when performed by experienced laparoscopic surgeons using standard laparoscopic instrumentation. SPA cholecystectomy may be safer than the NOTES approach at this time. It has to be determined whether this approach would benefit patients, other than cosmesis, compared with standard laparoscopic cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Single Port Access Laparoscopic Cholecystectomy (with video)

et al. 2008

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“…SILC is considered as a bridge between conventional laparoscopic cholecystectomy (CLC) and NOTES [5]. SILC was first described in 1997 [6], but it remained reserved for selected patients owing to technical difficulties [7,8]. With the advent of more sophisticated instruments, many reports on SILC cholecystectomy have demonstrated its feasibility and wide acceptability [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Cosmetic Outcome Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy in Rural Indian Population: A Randomized Clinical Trial

2014

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Persistent efforts are being made to reduce operative trauma and morbidity and to improve cosmesis following laparoscopic cholecystectomy. The trend is to reduce the number of incisions, and thus single-incision laparoscopic cholecystectomy (SILC) and natural orifice endoscopic surgery (NOTES) are becoming popular. There is a paucity of studies pertaining to cosmetic outcome after SILC and conventional laparoscopic cholecystectomy in rural Indian population. In the present study, the cosmetic outcome of SILC versus conventional laparoscopic cholecystectomy (CLC) in rural Indian population was evaluated. Sixty patients with gallstone disease were randomly assigned to two groups. In group A (n=30), CLC was performed, while group B (n=30) was subjected to SILC. The cosmetic outcome was evaluated using a body image questionnaire on the 7th and 30th postoperative days. On the 7th postoperative day, the body image score for SILC was 6.23±0.89 and for CLC, 8.26±1.08 (p<0.0001), while the cosmetic score for SILC was 19.56±1.07 and for CLC, 15±1.20 (p<0.0001). On the 30th postoperative day, the body image score for SILC was 5.50±0.68 and for CLC, 8±1.31 (p<0.0001), while the cosmetic score for SILC was 21.13±0.57 and for CLC, 15.63±1.06 (p<0.0001), which favored SILC over CLC. The patient perception and acceptance of SILC was better than that of CLC in terms of cosmetic outcome.

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“…This approach was first used in 1997 by Navarra et al in a laparoscopic cholecystectomy using two periumbilical incisions that were later joined to remove the gallbladder. 3 Although Single incision laparoscopic surgery (SILS) is not as revolutionary a concept as the initial introduction of laparoscopy, it is being evaluated and adopted by many. It is still beset with numerous concerns regarding higher costs, longer operating time, and, among many, a feeling of disbelief regarding its potential advantages.…”

Section: Historymentioning

confidence: 99%