Skip to main content
Log in

Single-port cholecystectomy in obese patients: our experience and a review of the literature

Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The objective of the present study was to compare the postoperative outcomes between obese and normal-weight patients undergoing single-port cholecystectomy (SPC) for gallstone disease.

Methods

A prospectively maintained SPC-database was retrospectively analyzed, and the outcomes of obese [body mass index (BMI) ≥30 kg/m2] and normal-weight patients were compared. All patients underwent SPC using the reusable X-Cone™ device.

Results

A total of 100 patients underwent SPC between July 2009 and September 2011. Seventeen obese patients (17 %) (median BMI 33.9 kg/m², range 30.0–38.8) were compared to 83 normal-weight patients (median BMI 24.1 kg/m², range 17.3–29.5). The length of the operation (median 75.5 min, range 42–156 vs. median 72.0 min, range 42–129; p = 0.51), conversion rate (N = 2 vs. N = 0; p = 1), postoperative complication rate (9.6 vs. 11.8%; p = 0.68), and postoperative hospital stay (median 3 days, range 1–14 vs. median 3 days, range 2–5; p = 0.74), were comparable for the normal-weight and obese patients.

Conclusion

The postoperative outcome of obese patients after SPC is not inferior to that of normal-weight patients undergoing the same operation. Therefore, the BMI should not be considered a key criterion in the patient selection for single-port surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Curcillo PG 2nd, Wu AS, Podolsky ER, Graybeal C, Katkhouda N, Saenz A, Dunham R, et al. Single-port-access (SPA) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc. 2010;24:1854–60.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  3. Rivas H, Varela E, Scott D. Single-incision laparoscopic cholecystectomy: initial evaluation of a large series of patients. Surg Endosc. 2010;24:1403–12.

    Article  PubMed  Google Scholar 

  4. 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 

  5. Yamashita Y, Kimura T, Matsumoto S. A safe laparoscopic cholecystectomy depends upon the establishment of a critical view of safety. Surg Today. 2010;40:507–13.

    Article  PubMed  Google Scholar 

  6. Han HJ, Choi SB, Kim CY, Kim WB, Song TJ, Choi SY. Single-incision multiport laparoscopic cholecystectomy for a patient with situs inversus totalis: report of a case. Surg Today. 2011;41:877–80.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  8. Reibetanz J, Wierlemann A, Germer CT, Krajinovic K. A novel technique for fundal retraction of the gallbladder in single-port cholecystectomy. J Laparoendosc Adv Surg Tech A. 2011;21:427–9.

    Article  PubMed  Google Scholar 

  9. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  PubMed  Google Scholar 

  10. Lakdawala MA, Muda NH, Goel S, Bhasker A. Single-incision sleeve gastrectomy versus conventional laparoscopic sleeve gastrectomy—a randomised pilot study. Obes Surg. 2011;21:1664–70.

    Article  PubMed  Google Scholar 

  11. Park K, Afthinos JN, Lee D, Koshy N, McGinty JJ, Teixeira JA. Single port sleeve gastrectomy: strategic use of technology to re-establish fundamental tenets of multiport laparoscopy. Surg Obes Relat Dis. 2011. doi:10.1016/j.soard.2011.06.003.

  12. Brody F, Vaziri K, Kasza J, Edwards C. Single incision laparoscopic cholecystectomy. J Am Coll Surg. 2010;210:e9–13.

    Article  PubMed  Google Scholar 

  13. Antoniou SA, Pointner R, Granderath FA. Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc. 2011;25:367–77.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  15. Roberts KE, Solomon D, Duffy AJ, Bell RL. Single-incision laparoscopic cholecystectomy: a surgeon’s initial experience with 56 consecutive cases and a review of the literature. J Gastrointest Surg. 2010;14:506–10.

    Article  PubMed  Google Scholar 

  16. Romanelli JR, Roshek TB 3rd, Lynn DC, Earle DB. Single-port laparoscopic cholecystectomy: initial experience. Surg Endosc. 2010;24:1374–9.

    Article  PubMed  Google Scholar 

  17. Qiu Z, Sun J, Pu Y, Jiang T, Cao J, Wu W. Learning curve of transumbilical single incision laparoscopic cholecystectomy (SILS): a preliminary study of 80 selected patients with benign gallbladder diseases. World J Surg. 2011;35:2092–101.

    Article  PubMed  Google Scholar 

  18. Solomon D, Bell RL, Duffy AJ, Roberts KE. Single-port cholecystectomy: small scar, short learning curve. Surg Endosc. 2010;24:2954–7.

    Article  PubMed  Google Scholar 

  19. Subhas G, Gupta A, Bhullar J, Dubay L, Ferguson L, Goriel Y, et al. Prolonged (longer than 3 hours) laparoscopic cholecystectomy: reasons and results. Am Surg. 2011;77:981–4.

    PubMed  Google Scholar 

Download references

Conflict of interest

Katica Krajinovic serves as a consultant for KARL STORZ GmbH, Tuttlingen, Germany. Christoph-Thomas Germer received travel grants from KARL STORZ. Joachim Reibetanz has no conflict of interest to declare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joachim Reibetanz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reibetanz, J., Germer, CT. & Krajinovic, K. Single-port cholecystectomy in obese patients: our experience and a review of the literature. Surg Today 43, 255–259 (2013). https://doi.org/10.1007/s00595-012-0238-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-012-0238-1

Keywords

Navigation