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Single-incision laparoscopic cholecystectomy: a systematic review of methodology and outcomes

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Abstract

Purpose

(1) To survey the dissemination of SILC; (2) to determine which SILC method has become mainstream; (3) to determine whether the characteristic complications vary according to the type of procedure.

Methods

An electronic search of PubMed, Databases@Ovid, and SciVerse Scopus between 2003/01/01 and 2012/12/31 was performed.

Results

The peak number of annually published articles was 70 in 2011. The most common procedures were single skin incision, the use of a SILS Port®, suture suspension and a 5-mm oblique scope. The intraoperative complications rate was 1.69 %. Postoperative complications occurred in 213/5283 cases. According to the surgical procedure, five factors (approach; P = 0.0017, gallbladder anchorage; P < 0.001, size; P = 0.049 and type; P < 0.001 of the scope, and size of the clip applier; P = 0.074) significantly affected the incidence of wound infection. The incidence of wound seroma/bleeding was significantly influenced by gallbladder anchorage (P = 0.009), the use of curved/articulated instruments (P = 0.048), and the diameter of the clip applier (P < 0.001).

Conclusion

To determine the best operative procedure for SILC, an analysis of uniform operative procedures is needed.

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References

  1. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84:695.

    Article  CAS  PubMed  Google Scholar 

  2. Allemann P, Schafer M, Demartines N. Critical appraisal of single port access cholecystectomy. Br J Surg. 2010;97:1476–80.

    Article  CAS  PubMed  Google Scholar 

  3. Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P. Single-incision laparoscopic surgery (SILS) vs. conventional multiport cholecystectomy: systematic review and meta-analysis. Surg Endosc. 2012;26:1205–13.

    Article  CAS  PubMed  Google Scholar 

  4. Hall TC, Dennison AR, Bilku DK, Metcalfe MS, Garcea G. Single-incision laparoscopic cholecystectomy: a systematic review. Arch Surg. 2012;147:657–66.

    Article  PubMed  Google Scholar 

  5. Mühe E. Die erste: cholecystecktomie durch das laparoskop (The first laparoscopic cholecystectomy). Langenbecks Arch Surg. 1986;369:804.

    Article  Google Scholar 

  6. Rosemurgy AS, Ross SB, Clark CW, Morton CA. Access for laparoendoscopic single site surgery. Diagn Ther Endosc. 2010. doi:10.1155/2010/943091.

    PubMed Central  PubMed  Google Scholar 

  7. Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo PG 2nd, et al. Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc. 2010;24:762–8.

    Article  PubMed  Google Scholar 

  8. Pfluke JM, Parker M, Stauffer JA, Paetau AA, Bowers SP, Asbun HJ, et al. Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg. 2011;212:113–8.

    Article  PubMed  Google Scholar 

  9. Tagaya N, Abe A, Kubota K. Needlescopic surgery for liver, gallbladder and spleen diseases. J Hepatobiliary Pancreat Sci. 2011;18:516–24.

    Article  PubMed  Google Scholar 

  10. Lee PC, Lai IR, Yu SC. Minilaparoscopic (needlescopic) cholecystectomy: a study of 1011 cases. Surg Endosc. 2004;18:1480–4.

    Article  PubMed  Google Scholar 

  11. Tanaka J, Andoh H, Koyama K. Minimally invasive needlescopic cholecystectomy. Surg Today. 1998;28:111–3.

    Article  CAS  PubMed  Google Scholar 

  12. Leggett PL, Bissell CD, Churchman-Winn R, Ahn C. Three-port microlaparoscopic cholecystectomy in 159 patients. Surg Endosc. 2001;15:293–6.

    Article  CAS  PubMed  Google Scholar 

  13. Podolsky ER, Curcillo PG 2nd. Reduced-port surgery: preservation of the critical view in single-port-access cholecystectomy. Surg Endosc. 2010;24:3038–43.

    Article  PubMed  Google Scholar 

  14. Hawasli A, Kandeel A, Meguid A. Single-incision laparoscopic cholecystectomy (SILC): a refined technique. Am J Surg. 2010;199:289–93.

    Article  PubMed  Google Scholar 

  15. Ramachandran CS, Arora V. Two-port laparoscopic cholecystectomy: an innovative new method for gallbladder removal. J Laparoendosc Adv Surg Tech A. 1998;8:303–8.

    Article  CAS  PubMed  Google Scholar 

  16. Grau-Talens EJ, Cattáneo JH, Giraldo R, Mangione-Castro PG, Giner M. Transcylindrical cholecystectomy under local anesthesia plus sedation: a pilot study. Endoscopy. 2010;42:395–9.

    Article  CAS  PubMed  Google Scholar 

  17. Sajid MS, Ladwa N, Kalra L, Hutson KK, Singh KK, Sayegh M. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials. World J Surg. 2012;36:2644–53.

    Article  PubMed  Google Scholar 

  18. Leung D, Yetasook AK, Carbray J, Butt Z, Hoeger Y, Denham W, et al. Single-incision surgery has higher cost with equivalent pain and quality-of-life scores compared with multiple-incision laparoscopic cholecystectomy: a prospective randomized blinded comparison. J Am Coll Surg. 2012;215:702–8.

    Article  PubMed  Google Scholar 

  19. Sinan H, Demirbas S, Ozer MT, Sucullu I, Akyol M. Single-incision laparoscopic cholecystectomy versus laparoscopic cholecystectomy: a prospective randomized study. Surg Laparosc Endosc Percutan Tech. 2012;22:12–6.

    Article  PubMed  Google Scholar 

  20. Gangl O, Hofer W, Tomaselli F, Sautner T, Függer R. Single incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC)-a matched pair analysis. Langenbecks Arch Surg. 2011;96:819–84.

    Article  Google Scholar 

  21. Bignell M, Hindmarsh A, Nageswaran H, Mothe B, Jenkinson A, Mahon D, et al. Assessment of cosmetic outcome after laparoscopic cholecystectomy among women 4 years after laparoscopic cholecystectomy: is there a problem? Surg Endosc. 2011;25:2574–7.

    Article  PubMed  Google Scholar 

  22. Keus F, de Jonge T, Gooszen HG, Buskens E, van Laarhoven CJ. Cost-minimization analysis in a blind randomized trial on small-incision versus laparoscopic cholecystectomy from a societal perspective: sick leave outweighs efforts in hospital savings. Trials. 2009. doi:10.1186/1745-6215-10-80.

    PubMed Central  PubMed  Google Scholar 

  23. Jacob D, Raakow R. Single-port versus multi-port cholecystectomy for patients with acute cholecystitis: a retrospective comparative analysis. Hepatobiliary Pancreat Dis Int. 2011;10:521–5.

    Article  PubMed  Google Scholar 

  24. Sasaki K, Watanabe G, Matsuda M, Hashimoto M. Original single-incision laparoscopic cholecystectomy for acute inflammation of the gallbladder. World J Gastroenterol. 2012;18:944–51.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Wong JS, Cheung YS, Chan KW, Chong CC, Lee KF, Wong J, et al. Single-incision laparoscopic cholecystectomy: from four wounds to one. Hong Kong Med J. 2011;17:465–8.

    PubMed  Google Scholar 

  26. Pisanu A, Reccia I, Porceddu G, Uccheddu A. Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC). J Gastrointest Surg. 2012;16:1790–801.

    Article  PubMed  Google Scholar 

  27. Khambaty F, Brody F, Vaziri K, Edwards C. Laparoscopic versus single-incision cholecystectomy. World J Surg. 2011;35:967–72.

    Article  PubMed  Google Scholar 

  28. Han HJ, Choi SB, Kim WB, Choi SY. Single-incision multiport laparoscopic cholecystectomy: things to overcome. Arch Surg. 2011;146:68–73.

    Article  PubMed  Google Scholar 

  29. Erbella J Jr, Bunch GM. Single-incision laparoscopic cholecystectomy: the first 100 outpatients. Surg Endosc. 2010;24:1958–61.

    Article  PubMed  Google Scholar 

  30. Rupp CC, Farrell TM, Meyer AA. Single incision laparoscopic cholecystectomy using a “wo-port” technique is safe and feasible: experience in 101 consecutive patients. Am Surg. 2011;77:916–21.

    PubMed  Google Scholar 

  31. Catarci M, Carlini M, Gentileschi P, Santoro E. Major and minor injury during the creation of pneumoperitoneum: a multicenter study on 12919 cases. Surg Endo. 2001;15:566–9.

    Article  CAS  Google Scholar 

  32. Dominguez G, Durand L, De Rosa J, Danguise E, Arozamena C, Ferraina PA. Retraction and triangulation with neodymium magnetic forceps for single-port laparoscopic cholecystectomy. Surg Endosc. 2009;23:1660–6.

    Article  PubMed  Google Scholar 

  33. Yin H, Wang Z, Xu J, Guan Y, Zhai B, Zhao L. A specific instrument to facilitate single-incision laparoscopic cholecystectomy: an initial experience. Surg Innov. 2011;18:289–93.

    Article  PubMed  Google Scholar 

  34. Dapri G, Casali L, Bruyns J, Himpens J, Cadiere GB. Single-access laparoscopic surgery using new curved reusable instruments: initial hundred patients. Surg Technol Int. 2010;20:21–35.

    PubMed  Google Scholar 

  35. Sodergren M, McGregor C, Farne HA, Cao J, Lv Z, Purkayastha S, et al. A randomised comparative study evaluating learning curve of novices in a basic single-incision laparoscopic surgery task. J Gastrointest Surg. 2013;17:567–75.

    Google Scholar 

  36. Sinha R. Transumbilical single-incision laparoscopic cholecystectomy with conventional instruments and ports: the way forward? J Laparoendosc Adv Surg Tech A. 2011;21:497–503.

    Article  PubMed  Google Scholar 

  37. Garcia-Henriquez N, Shah SR, Kane TD. Single-incision laparoscopic cholecystectomy in children using standard straight instruments: a surgeon’s early experience. J Laparoendosc Adv Surg Tech A. 2011;21:555–9.

    Article  PubMed  Google Scholar 

  38. Cantore F, Colombo EM, Giuseppe MD, Biondi A, Rausei S, Dionigi G, et al. Single access cholecystectomy using standard laparoscopic instruments. Updates Surg. 2011;63:31–4.

    Article  PubMed  Google Scholar 

  39. Chang SK, Tan SS, Kok YO. Early experience in single-site laparoscopic cholecystectomy. Singapore Med J. 2012;53:377–80.

    PubMed  Google Scholar 

  40. Trastulli S, Cirocchi R, Desiderio J, Guarino S, Santoro A, Parisi A, et al. Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy. Br J Surg. 2013;100:191–208.

    Article  CAS  PubMed  Google Scholar 

  41. Noguera JF, Dolz C, Cuadrado A, Olea J, García J. Flexible single-incision surgery: a fusion technique. Surg Innov. 2012. doi:10.1177/1553350612451355.

    PubMed  Google Scholar 

  42. Joseph M, Phillips MR, Farrell TM, Rupp CC. Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg. 2012;256:1–6.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to acknowledge the valuable help of a library coordinator, Mr. Mikosiba, and the secretarial assistance of Ms. Aoyagi and Ms. Nakabayashi with regard to the database queries and article collection.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan

    Masato Yamazaki & Keiji Koda

  2. Faculty of Regional Health Therapy, Teikyo Heisei University, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan

    Hideki Yasuda

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  1. Masato Yamazaki
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Correspondence to Masato Yamazaki.

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Yamazaki, M., Yasuda, H. & Koda, K. Single-incision laparoscopic cholecystectomy: a systematic review of methodology and outcomes. Surg Today 45, 537–548 (2015). https://doi.org/10.1007/s00595-014-0908-2

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