Single-Incision Laparoscopic Cholecystectomy

Hall, Thomas C.; Dennison, Ashley R.; Bilku, D.; Metcalfe, Matthew S.; Garcea, Giuseppe

doi:10.1001/archsurg.2012.814

Cited by 61 publications

(64 citation statements)

References 58 publications

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“…There are three main approaches mentioned in the literature to perform SILC. One technique uses special purpose-made access devices/ports (like TriPort) for introducing the laparoscope and instruments which are usually roticulating ones [5]. The second technique includes passing 3-mm trocars side by side through the fascia after exposing a vide area through a single umbilical incision [6].…”

Section: Introductionmentioning

confidence: 99%

Transumbilical SILC Using Conventional Laparoscopic Instruments—Initial Experience in a Resource-Limited Setting

2013

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In the era of minimal access, single-incision laparoscopic surgery is gaining popularity. Expensive ports, disposable hand instruments and flexible endoscopes have been utilised, but they increase the cost of operation. We report our initial experience of two-trocar single-incision laparoscopic cholecystectomy (SILC) in 70 patients using conventional instruments that can be adapted as a novel technique in achieving minimal trauma and aesthetic results in resourcelimited hospitals. Between September 2011 and September 2012, 70 consecutive patients underwent an attempted SILC in a single centre. The mean age of the patients was 42 years (range 18-65 years). There were 12 males and 58 females with a male-to-female ratio of 1:4.8. Transumbilical incision was used to access the abdomen, and two 10-mm ports/ trocars were placed through the single incision side by side, maintaining a facial bridge of 5-8 mm in between. Gall bladder was manipulated through two strategically placed traction sutures to expose the Callot's triangle. Mean operation time in our series was 42.12 min (range 22-90 min). There was no need of additional sutures. Bleeding was minimal in nearly all cases. The mean hospital stay was 1.06 days (range 1-4 days). The post-operative analgesic requirement was one dose in 60.4 % patients. Additional port was required in two of our patients. Two patients needed conversion to open surgery. There was no major complication or mortality in our series. This technique of two-trocar SILC using conventional instruments can be adapted as a less invasive surgical procedure in resource-limited hospitals in selected group of patients. Cosmetic result, reduced pain, short hospital stay and the degree of satisfaction appear to be significant with this technique.

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Section: Introductionmentioning

confidence: 99%

Transumbilical SILC Using Conventional Laparoscopic Instruments—Initial Experience in a Resource-Limited Setting

2013

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“…6 Additional studies have confirmed there is no benefit conferred from the SILC within the 6, 8 or 24 hours postoperative period. 4,7 In this study, the umbilical port had the highest median pain score and was reported as the site painful for the longest period after the operation.…”

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confidence: 98%

“…In Hall et al 6 systematic review of studies, they reported similar or worse postoperative pain scores in 10 out of 13 articles comparing the SILC to the SLC. 6 Additional studies have confirmed there is no benefit conferred from the SILC within the 6, 8 or 24 hours postoperative period.…”

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confidence: 99%

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Pain and Cosmesis following Four-Port Laparoscopic Cholecystectomy: The Patient View

Patel¹,

Neal²,

Dennison³

et al. 2014

WJOLS

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“…Classical laparoscopic cholecystectomy (CLC) involves 4 ports while the most novel 'single port' technique only requires 1 incision on the abdominal wall [2]. The latter technique is thought to decrease surgical trauma and improve cosmesis [3] although there are reports pointing out that CLC is also feasible in terms of cosmesis [4].…”

mentioning

confidence: 99%

Single Port vs. Four Port Cholecystectomy – Randomized Trial on Quality of Life

Sulu¹,

Yildiz²,

Ilingi³

et al. 2015

Adv Clin Exp Med

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Background. Classical laparoscopic cholecystectomy involves four ports while most novel 'single port' technique only requires one incision on the abdominal wall. This technique is thought to decrease surgical trauma and improve cosmesis although there are reports pointing out that classical laparoscopic cholecystectomy is also feasible in terms of cosmesis. Objectives. In this study we tried to determine if there are certain advantages in quality of life after single port surgery which would justify its utilization instead of classical laparoscopic cholecystectomy. Material and Methods. This is a prospective randomized study which enrolled 30 patients randomized either into classical laparoscopic cholecystectomy or single port surgery. The primary endpoint was patient satisfaction after surgery. This was assessed with short form 36 and gastrointestinal quality of life index (first preoperatively and then 3 months postoperatively) and a visual analogue scale on the first and seventh days. Results. There was not a statistically significant difference between groups in the emotional role, social functions, mental health, vitality and general health subscales of short form 36. At the end of 12 weeks, both groups demonstrated increases in the gastrointestinal and social subscales of the gastrointestinal quality of life index. There was not a statistically significant difference between groups when the visual analogue scale scores on first and seventh days were compared. Conclusions. The equal length of hospitalization, patient quality of life and pain perception and the longer operative times, high likelihood of incisional hernia and surgical site infection call into question the utilization of single port surgery, as it does not seem to confer an advantage over classical laparoscopic cholecystectomy (Adv Clin Exp Med 2015, 24, 3, 469-473).

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Single-Incision Laparoscopic Cholecystectomy

Cited by 61 publications

References 58 publications

Transumbilical SILC Using Conventional Laparoscopic Instruments—Initial Experience in a Resource-Limited Setting

Transumbilical SILC Using Conventional Laparoscopic Instruments—Initial Experience in a Resource-Limited Setting

Pain and Cosmesis following Four-Port Laparoscopic Cholecystectomy: The Patient View

Single Port vs. Four Port Cholecystectomy – Randomized Trial on Quality of Life

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