Single Port Laparoscopic Cholecystectomy: Technical Aspects and Results

Abstract

Background: The search for less traumatic surgical procedures without compromising efficacy and safety, together with the technological advances and greater experience of the teams, led to the development of operative techniques with increasingly smaller incisions, the so-called “minimally invasive surgeries”. Aim: To evaluate the technical aspects and results of single port cholecystectomy. Method: Were analyzed 170 patients between 18-74 years submitted to videolaparoscopic cholecystectomies by single port, regardless of elective or urgent indication, without restriction of patient selection. Results: Among the 170 operations, 158 were exclusively performed by single port, and the conversion rate was 7% (inclusion of other accessory trocars or conversion to multiportal). Conversion to open surgery occurred in three cases (1.76%). The mean surgical time was 67.97 min, showing a marked decrease when was reached close to 50 cases and a stabilization after 100 surgeries. The overall complication rate was 10%, with minor complications such as: incisional pain, hematomas, granulomas, port access hernias (9.41%). Conclusion: Single port cholecystectomy can, after standardization and surgical team training, be a safe surgical procedure associated with a recognized aesthetic advantage.

Does Male Gender Increase the Risk of Laparoscopic Cholecystectomy?

“…Gallstone is one of the most common diseases, with a prevalence of about 10% in the general population of Brazil and in most western countries 6 , 9 , 10 .…”

During which period should we avoid cholecystectomy in patients who underwent endoscopic retrograde cholangiopancreatography?

“…(1)(2)(3) Choledocholithiasis can be diagnosed with imaging methods, such as abdominal ultrasound, magnetic resonance (MR) cholangiography or intraoperative cholangiography, which identifies choledocholithiasis in approximately 10% of asymptomatic patients, which warrants its being used routinely. (3)(4)(5) Endoscopic retrograde cholangiopancreatography (ERCP) is highly sensitive and specific for choledocholithiasis, but it is most frequently used after a confirmed diagnosis of choledocholithiasis, for therapeutic purposes. (3,(5)(6)(7) ERCP can be performed before, during or after cholecystectomy, and patients diagnosed with choledocholithiasis before surgical treatment or at high risk for complications, such as those with cholangitis or dilated biliary tree, must undergo preoperative ERCP.…”

Colecistectomia: técnicas e suas indicações / Cholecystectomy: techniques and their indications

“…Técnica utilizadaO paciente é colocado em posição dorsal horizontal, enquanto o cirurgião geralmente fica entre as pernas. Há também o assistente com a câmera e o instrumentador 10. …”