Single-Incision Laparoscopic Cholecystectomy: A Surgeon’s Initial Experience with 56 Consecutive Cases and a Review of the Literature
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- Roberts, K.E., Solomon, D., Duffy, A.J. et al. J Gastrointest Surg (2010) 14: 506. doi:10.1007/s11605-009-1116-z
We describe the results of a single surgeon’s initial experience with single-incision laparoscopic cholecystectomy through his first 56 cases and provide a brief literature review on the development of this technique.
Through a 2-cm vertical transumbilical incision, three 5-mm ports were placed using the Veress technique. One extracorporeal suture was utilized to provide cephalad retraction of the fundus, and a roticulating instrument grasping the infundibulum provided lateral retraction. The hilum was dissected, and the cystic duct and artery were clipped and divided. One 5-mm port was upgraded to a 10-mm port to allow the introduction of a retrieval bag, and the gallbladder was removed from the abdomen.
Of 56 patients, 54 successfully underwent a single-incision laparoscopic cholecystectomy. Two patients required conversion to either a conventional laparoscopic cholecystectomy or open cholecystectomy. The average age was 41 years (18–77) and the average BMI, 30.2 kg/m2 (18.5–44.6). Mean operative time was 80 min (41–186). Length of stay was 0.3 days (0–2). The complication rate was 3/56 (5.4%).
Our results suggest that single-incision laparoscopic cholecystectomy is a safe and effective alternative to four-port laparoscopic cholecystectomy that provides surgeons with an alternative minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus.