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Surgical Endoscopy

, Volume 24, Issue 8, pp 1854–1860 | Cite as

Single-port-access (SPATM) cholecystectomy: a multi-institutional report of the first 297 cases

  • Paul G. CurcilloII
  • Andrew S. Wu
  • Erica R. Podolsky
  • Casey Graybeal
  • Namir Katkhouda
  • Alex Saenz
  • Robert Dunham
  • Steven Fendley
  • Marc Neff
  • Chad Copper
  • Marc Bessler
  • Andrew A. Gumbs
  • Michael Norton
  • Antonio Iannelli
  • Rodney Mason
  • Ashkan Moazzez
  • Larry Cohen
  • Angela Mouhlas
  • Alex Poor
Article

Abstract

Background

An important aspect of a new surgical technique is whether it can be performed by other surgeons in other institutions. The authors report the first 297 cases in a multi-institutional and multinational review of laparoscopic cholecystectomy performed via a single portal of entry.

Methods

Data were collected retrospectively for the initial patients undergoing single-port cholecystectomy by 13 surgeons who performed these procedures in their institutions after training by the authors. The review included operative time, blood loss, incision length, length of hospital stay (LOS), necessary additional trocars, and other parameters important to cholecystectomy. A database of all the single-port-access (SPA) surgeries performed by the surgeons included demographic and procedural details, LOS, complications, and initial follow-up data.

Results

To date, 297 single-port cholecystectomies have been performed for a variety of diagnoses, primarily cholelithiasis. The average operative time was 71 min, and the average LOS was 1–2 days. The average blood loss was minimal. The use of additional port sites outside the umbilicus occurred in 34 of the cases. Of the 35 intraoperative cholangiograms performed, 34 were successful. No significant complications occurred except for seromas and minor postoperative wound infections. These results are comparable with those for standard multiport cholecystectomy. In addition, no access site hernias (ASH) occurred.

Conclusions

The findings demonstrate that SPA surgery is an alternative to multiport laparoscopy with fewer scars and better cosmesis. One factor affecting the rate for adoption of SPA surgery among other surgeons is the reproducibility of this new procedure. Although this study had insufficient data to determine fully the benefits of SPA surgery, the feasibility of this procedure with safe, acceptable results was demonstrated in this initial large series across multinational institutions.

Keywords

Cholecystectomy Laparoscopic cholecystectomy Multi-institutional Reduced-port surgery Single-port access SPA cholecystectomy Single incision laparoscopic cholecystectomy 

Notes

Disclosures

Andrew S. Wu, Erica R. Podolsky, Namir Katkhouda, Alex Saenz, Robert Dunham, Marc Neff, Chad Copper, and Rodney Mason have no conflicts of interest or financial ties to disclose. Paul G. Curcillo speaks about single-port-access surgery for Storz Endoscopy, Ethicon Inc., Olympus, Inc., and Microline. Casey GraybealI provides educational and instructional assistance to Ethicon by virtue of telesurgery, which is covered by a “consulting” agreement, and has a consulting agreement with Carefusion (previously Cardinal Health) to serve on their Surgical Advisory Board. Marc Bessler receives fellowship support from Covidien and Ethicon and does consulting for these institutions and Olympus as well. Andrew A. Gumbs is a consultant for Ethicon, a proctor and course instructor for Covidien, a proctor for Novare Surgical and course instructor and lecturer for Applied Medical. Michael Norton is a stockholder in Axcess Instruments Inc. Dr Iannelli is a consultant for Covindien Inc. for single-port laparoscopic surgery. Ashkan Moazzez, Larry Cohen, Angela Mouhlas, and Alex Poor have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Paul G. CurcilloII
    • 1
  • Andrew S. Wu
    • 1
  • Erica R. Podolsky
    • 1
  • Casey Graybeal
    • 2
  • Namir Katkhouda
    • 3
  • Alex Saenz
    • 4
  • Robert Dunham
    • 5
  • Steven Fendley
    • 6
  • Marc Neff
    • 7
  • Chad Copper
    • 8
  • Marc Bessler
    • 9
  • Andrew A. Gumbs
    • 10
  • Michael Norton
    • 11
  • Antonio Iannelli
    • 12
  • Rodney Mason
    • 3
  • Ashkan Moazzez
    • 3
  • Larry Cohen
    • 7
  • Angela Mouhlas
    • 13
  • Alex Poor
    • 13
  1. 1.Department of SurgeryDrexel University College of MedicinePhiladelphiaUSA
  2. 2.Northeast Georgia Surgical AssociatesGainesvilleUSA
  3. 3.University of Southern CaliforniaLos AngelesUSA
  4. 4.Department of SurgeryClinica Sagrada FamiliaBarcelonaSpain
  5. 5.Queen of the Valley Medical CenterNapaUSA
  6. 6.Wiregrass Surgical AssociatesDothanUSA
  7. 7.Surgical Care AssociatesCherry HillUSA
  8. 8.Northeast Georgia Medical CenterGainesvilleUSA
  9. 9.Columbia University Medical CenterNew YorkUSA
  10. 10.Fox-Chase Cancer CenterDothanPhiladelphiaUSA
  11. 11.Trinity Mother Frances Clinic SurgeryTylerUSA
  12. 12.Chirurgien des HopitauxUniversity of Nice-Sophia-AntipolisNiceFrance
  13. 13.Drexel University College of MedicinePhiladelphiaUSA

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