Single-incision laparoscopic cholecystectomy versus mini-laparoscopic cholecystectomy: A randomized clinical trial study

Abstract

Background:Surgical technique using small-diameter instruments and single-incision laparoscopy are two new options for less invasive laparoscopic cholecystectomy (LC). In this study, we have compared mini-LC (MLC) with single-incision LC (SILC).Materials and Methods:This study is a randomized clinical trial conducted on the patients diagnosed with symptomatic cholelithiasis who underwent LC. Forty patients were randomized to two equal groups of MLC and SILC. They were compared in terms of demographic data, operation time, and surgical complications.Results:Baseline characteristics were similar in two groups. Operation time in MLC was significantly shorter than that in SILC (45.1 ± 69 min vs 63.75 ± 7.57 min, P-value < 0.001). Also, the total length of the wound in SILC group was shorter than that in MLC group (P-value < 0.003). Postoperative pain scores were similar in two groups. Hospital stay was shorter in MLC (1.2 ± 0.6 days vs 1.6 ± 0.8 days, P < 0.021). There was no difference in postoperative complications in two groups.Conclusion:MLC because of less operation time is preferred than SILC. Also, by subjective measures, it was a more comfortable method compared to SILC.

Minilaparoscopic versus single incision cholecystectomy for the treatment of cholecystolithiasis: a meta-analysis and systematic review

“…One study [ 16 ] was excluded for unavailability of data and one study [ 17 ] was removed for hysterectomy. Eventually, 6 publications (4 RCTs [ 18 – 21 ] and 2 nRCSs [ 22 , 23 ]) involving 2764 patients were included for further evaluation (Table 1 ). Then a flow diagram summarizing the systematic literature search is shown in Fig.…”

“…Three studies [ 21 – 23 ] used a three-arm design and compared MLC, SILC and LC. The other three studies [ 18 – 20 ] employed a two-arm design and made comparison between MLC and SILC.…”

“…Four RCTs [ 18 – 21 ] included were assessed: according to the Cochrane Collaboration’s tool, the generation of allocation sequence was adequate in 3 (75%) trials; allocation concealment was adequate in 3 (75%) trials; blinding of participants and personnel was adequate in 1 (25%) trial; blinding of outcome assessment was dequate in 3 (75%) trials; and the follow-up data were adequate in 4 trials (100%); Outcome data were adequate in 1 trial (25%). Then 1 (25%) trial was considered to be of low quality (high risk) and the other 3 (75%) were considered of high quality (low risk).…”

“…Five included trials [ 18 – 21 , 23 ] reported the operating time, and a significant difference in the random-effects model (MD -10.49; 95% CI -18.10, −2.88; P = 0.007) (Fig. 2 ).…”

“…Four trials [ 18 , 20 , 21 , 23 ] reported the conversion rate to LC. Although the conversion rate was lower in the MLC group, no statistical significance was found between the two procedures (RD -0.02; 95% CI -0.07, 0.02; P = 0.29) (Fig.…”