World Journal of Surgery

, Volume 38, Issue 1, pp 25–32 | Cite as

Single-incision and NOTES Cholecystectomy, Are There Clinical or Cosmetic Advantages When Compared to Conventional Laparoscopic Cholecystectomy? A Case–control Study Comparing Single-incision, Transvaginal, and Conventional Laparoscopic Technique for Cholecystectomy

  • Peter B. van den Boezem
  • Simone Velthuis
  • Harm J. Lourens
  • Miguel A. Cuesta
  • Colin Sietses



The aim of the present study was to compare the clinical and cosmetic results of transvaginal hybrid cholecystectomy (TVC), single-port cholecystectomy (SPC), and conventional laparoscopic cholecystectomy (CLC). Recently, single-incision laparoscopic surgery and natural orifice transluminal endoscopic surgery have been developed as minimally invasive alternatives for CLC. Few comparative studies have been reported.


Female patients with symptomatic gallstone disease who were treated in 2011 with SPC, TVC, or CLC were entered into a database. Patients were matched for age, body mass index, and previous abdominal surgery. After the operation all patients received a survey with questions about recovery, cosmesis, and body image.


A total of 90 patients, 30 in each group, were evaluated. Median operative time for CLC was significantly shorter (p < 0.001). There were no major complications. Length of hospital stay, postoperative pain, and postoperative complications were not significantly different. The results for cosmesis and body image after the transvaginal approach were significantly higher. None of the sexually active women observed postoperative dyspareunia.


Both SPC and TVC are feasible procedures when performed in selected patients. CLC is a faster procedure, but other clinical outcomes and complication rates were similar. SPC, and especially TVC, offer a better cosmetic result. Randomized trials are needed to specify the role of SPC and TVC in the treatment of patients with symptomatic gallstone disease.


Body Image Bile Duct Injury Conventional Laparoscopic Cholecystectomy Transvaginal Approach Symptomatic Gallstone Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare that they have no conflicts of interest or financial ties to disclose.


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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Peter B. van den Boezem
    • 1
  • Simone Velthuis
    • 1
  • Harm J. Lourens
    • 2
  • Miguel A. Cuesta
    • 3
  • Colin Sietses
    • 1
  1. 1.Department of SurgeryGelderse Vallei HospitalEdeThe Netherlands
  2. 2.Department of AnaesthesiologyGelderse Vallei HospitalEdeThe Netherlands
  3. 3.Department of SurgeryVrije Universiteit Medical CenterAmsterdamThe Netherlands

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