Single-Incision Laparoscopic Cholecystectomy: Initial Experience with Critical View of Safety Dissection and Routine Intraoperative Cholangiography

Rawlings, Arthur; Hodgett, Steven; Matthews, Brent D.; Strasberg, Steven M.; Quasebarth, Mary; Brunt, L. Michael

doi:10.1016/j.jamcollsurg.2010.02.038

Cited by 90 publications

(53 citation statements)

References 44 publications

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“…One 10-mm umbilical port, one 10-mm subxiphoid port, and a 5-mm port in the right subcostal area of the midclavicular line were installed, the standard rigid 10-mm 08 optics and standard straight instruments were used, the gallbladder was pulled to expose Calot's triangle and the dissection made to obtain a critical view, 10 the cyst duct and the artery were ligated with titanium clips, and the gallbladder dissection of the hepatic bed was performed with an electrosurgical hook.…”

Section: Lc3pmentioning

confidence: 99%

One, Two, or Three Ports in Laparoscopic Cholecystectomy?

Justo-Janeiro

Vincent²,

Lara

et al. 2014

International Surgery

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Single-port laparoscopic cholecystectomy (LC) has been compared with 3-or 4-port LC. To our knowledge, there are no studies comparing the 3-, 2-, and 1-port techniques. Patients were randomized into 3 groups: LC 1-port using SILS, LC 2-port using a laparoscope with a working channel, and LC 3-port using the standard ports. Pain was evaluated at recovery, 4 hours, 24 hours, day 5, and day 8, using an analog visual scale. Homogenous groups in their demographic characteristics; all confirmed gallbladder lithiasis. At recovery, there was less pain in group 1 (P ¼ 0.002); at 4 hours pain was similar in all groups (P ¼ 0.899); at 24 hours there was less pain in groups 2 and 3 (P ¼ 0.031); and at days 5 and 8 there was marginal (P ¼ 0.053) and significant (P ¼ 0.003) relevance. In terms of pain perception, LC performed through 1 port does not offer advantages when compared with 2 or 3 ports. More clinical trials are needed to confirm these data.

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Section: Lc3pmentioning

confidence: 99%

One, Two, or Three Ports in Laparoscopic Cholecystectomy?

Justo-Janeiro

Vincent²,

Lara

et al. 2014

International Surgery

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“…En relación a la realización de la colecistectomía por puerto único, encontramos en la literatura experiencias que seleccionan los pacientes por IMC (excluyen obesos) y por complejidad técnica (excluyen casos difíciles) 5,8,20,[22][23][24][25][26] . En nuestra serie hemos operado todo tipo de pacientes sin exclusión por IMC ni por complejidad de la patología biliar, por lo que nuestros resultados nos parecen satisfactorios.…”

Section: Discussionunclassified

“…Rodríguez 5 , reporta hospitalización postoperatoria entre 12 y 36 horas. Algunos autores refi eren hospitalizaciones de 24 ho-ras 13,14,19,23,[26][27][28][29][30] , y otros comunican entre 1,5 y 2,5 días de estadía 15,28,[31][32][33] . Encontramos autores con hospitalizaciones menores a un día 22,24,34,35 .…”

Section: Discussionunclassified

“…Sólo 1 paciente (uno de los 2 con gangrena vesicular y bilirragia postoperatoria) requirió asistencia de un tercer puerto por difi cultades técnicas y no fue necesario convertir. Existen series con selección de pacientes cuyos casos no son complicados y ellos no reportan conversiones 5,23,26 . En nuestra experiencia no hubo exclusión de pacientes con patología complicada y el porcentaje de conversión puede considerarse bajo.…”

Section: Discussionunclassified

“…Dentro de las precoces, tenemos una onfalitis y seroma que se resuelve sin problemas. La literatura reporta con frecuencia este evento 12,23,28,32,38,39 . Otra complicación precoz que tuvimos es una bilirragia postoperatoria por conducto de Luschka, manejado conservadoramente sólo con drenaje y que se resuelve al quinto día postoperatorio.…”

Section: Discussionunclassified

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Colecistectomía laparoscópica por puerto umbilical asistido

Solano¹,

2012

Rev Chil Cir

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Transumbilical laparoscopic cholecystectomy assisted with a second port. Experience in 60 patientsBackground: Transumbilical laparoscopic surgery offers substantial esthetic benefi ts. The use of a second port to introduce a second trocar, reduces the need of special or articulated instruments. Aim: To report the experience with transumbilical cholecystectomy, assisted using a second port, to reduce technical complexity. Patients and Methods: The surgical technique was prospectively evaluated in 60 patients aged 18 to 77 years (39 women), that required a cholecystectomy. All had a surgical risk classifi ed according to the American Society of Anesthesiologists (ASA) as I or II. Patients with gallbladder cancer, choledocholithiasis, were excluded. Two trocar (10 and 5 mm) were introduced by transumbilical incision and other one 5 mm trocar was introduced in the right iliac fossa for 0° frontal optics. Results: The mean operative time was 72 minutes (range 35-165). Fifty seven patients had a 24 h hospital stay. Two patients had to be converted to open surgery due to a complex pedicle dissection and one patient required an additional trocar. There were three complications. An umbilical seroma, a bile leakage through a Luschka duct, that was managed conservatively and one bile tract stenosis, that appeared four months after the operation and required surgical repair. Conclusions: Transumbilical cholecystectomy using a second additional port was a successful procedure, with similar esthetic results as single port surgery, but less costly.

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Is Single-Incision Laparoscopic Cholecystectomy Really Beneficial?

Berney

2012

Arch Surg

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Single-Incision Laparoscopic Cholecystectomy: Initial Experience with Critical View of Safety Dissection and Routine Intraoperative Cholangiography

Cited by 90 publications

References 44 publications

One, Two, or Three Ports in Laparoscopic Cholecystectomy?

One, Two, or Three Ports in Laparoscopic Cholecystectomy?

Colecistectomía laparoscópica por puerto umbilical asistido

Is Single-Incision Laparoscopic Cholecystectomy Really Beneficial?

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