TITLE:
Single-Incision Laparoscopic Cholecystectomy with Conventional Instruments: A Surgeon’s Initial Experience
AUTHORS:
Mehmet Zafer Sabuncuoglu, Aylin Sabuncuoglu, Isa Sozen, Gulsum Tozlu, Mehmet Fatih Benzin, Recep Cetin
KEYWORDS:
Laparoscopic Cholecystectomy, Single Incision, Minimal Invasion, Gallbladder Diseases, Complications
JOURNAL NAME:
Surgical Science,
Vol.5 No.7,
July
22,
2014
ABSTRACT: Purpose: Since the early
1990s, laparoscopic cholecystectomy has become the gold standard for
cholecystectomy. Single-incision laparoscopic surgery (SILS) is a rapidly
evolving field as a bridge between traditional laparoscopic surgery and natural
orifice transluminal endoscopic. The results are presented here of a single
surgeon’s initial experience with single-incision laparoscopic cholecystectomy with
conventional laparoscopic instruments through his first 11 cases. Materials and
Methods: A single curved intra-umbilical 25-mm incision was made by pulling out
the umbilicus. A 12-mm trocar was placed through an open approach, and the
abdominal cavity was explored with a 10-mm laparoscope. One 10-mm and one 5-mm
port were inserted laterally from the laparoscope port. Dissection was
performed using a dissector, which was not articulated. The gallbladder was
investigated with an Endograsper, which was not articulated either. The hilum
was dissected, and the cystic duct and artery were clipped and divided.
Results: The patients are comprised of 9 females and 2 males with a mean age of
43.3 years and mean body mass index (BMI) of 27.6 kg/m2. Open
cholecystectomy was not required. The mean operative time was 69.9 min. Length
of stay was only one day. All procedures were completed successfully without
any perioperative or postoperative complications. In all cases, there was no
need to extend the skin incision. Postoperative follow-up did not reveal any
umbilical wound complications. The cosmetic results were scored as excellent by
all patients. Conclusion: These results suggest that single-incision
laparoscopic cholecystectomy is feasible, safe and effective and a promising
alternative method to four-port and SILS-port laparoscopic cholecystectomy and
as scarless abdominal surgery for the treatment of some patients with
gallbladder disease with standard laparoscopic instruments.