Journal of Gastrointestinal Surgery

, Volume 16, Issue 8, pp 1618–1628

Single-Incision Laparoscopic Cholecystectomy vs. Conventional Laparoscopic Cholecystectomy: a Meta-analysis of Randomized Controlled Trials

  • Pankaj Garg
  • Jai Deep Thakur
  • Mahak Garg
  • Geetha R. Menon
Review Article

Abstract

Introduction

We analyzed different morbidity parameters between single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC).

Methods

Pubmed, Ovid, Embase, SCI database, Cochrane, and Google Scholar were searched. The primary endpoints analyzed were cosmetic result and the postoperative pain (at 6 and 24 h) and the secondary endpoints were operating time, hospital stay, incidence of overall postoperative complications, wound-related complications, and port-site hernia.

Results

Six hundred fifty-nine patients (SILC—349, CLC—310) were analyzed from nine randomized controlled trials. The objective postoperative pain scores at 6 and 24 h and the hospital stay were similar in both groups. The total postoperative complications, wound-related problems, and port-site hernia formation, though higher in SILC, were also comparable in both groups. SILC had significantly favorable cosmetic scoring compared to CLC [weighted mean difference = 1.0, p = 0.0001]. The operating time was significantly longer in SILC [weighted mean difference = 15.63, p = 0.0001].

Conclusions

Single-incision laparoscopic cholecystectomy does not confer any benefit in postoperative pain (6 and 24 h) and hospital stay as compared to conventional laparoscopic cholecystectomy while having significantly better cosmetic results at the same time. Postoperative complications, though higher in SILC, were statistically similar in both the groups.

Keywords

Single incision Cholecystectomy Laparoscopic Meta-analysis Cosmetic Postoperative pain Conventional 

References

  1. 1.
    Tacchino R, Greco F, Matera D Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 2009; 23:896–899.PubMedCrossRefGoogle Scholar
  2. 2.
    Lee PC, Lo C, Lai PS, et al. Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg 2010; 97:1007–1012.PubMedCrossRefGoogle Scholar
  3. 3.
    Marks J, Tacchino R, Roberts K, et al. Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data. Am J Surg 2011; 201:369–372; discussion 372–363.PubMedCrossRefGoogle Scholar
  4. 4.
    Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, et al. Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 2010; 24:1842–1848.PubMedCrossRefGoogle Scholar
  5. 5.
    Aprea G, Coppola Bottazzi E, Guida F, Masone S, Persico G Laparoendoscopic single site (LESS) versus classic video-laparoscopic cholecystectomy: a randomized prospective study. J Surg Res 2011; 166:e109–112.PubMedCrossRefGoogle Scholar
  6. 6.
    Lai EC, Yang GP, Tang CN, Yih PC, Chan OC, Li MK Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. Am J Surg 2011; 202:254–258.PubMedCrossRefGoogle Scholar
  7. 7.
    Lirici MM, Califano AD, Angelini P, Corcione F Laparo-endoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial. Am J Surg 2011; 202:45–52.PubMedCrossRefGoogle Scholar
  8. 8.
    Phillips MS, Marks JM, Roberts K, et al. Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy. Surg Endosc 2012; 26:1296–1303.Google Scholar
  9. 9.
    Zheng M, Qin M, Zhao H Laparoendoscopic single-site cholecystectomy: A randomized controlled study. Minim Invasive Ther Allied Technol 2012; 21:113–117.Google Scholar
  10. 10.
    Cao ZG, Cai W, Qin MF, Zhao HZ, Yue P, Li Y Randomized clinical trial of single-incision versus conventional laparoscopic cholecystectomy: short-term operative outcomes. Surg Laparosc Endosc Percutan Tech 2011; 21:311–313.PubMedCrossRefGoogle Scholar
  11. 11.
    Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S Randomized Controlled Trial Comparing Single-Port Laparoscopic Cholecystectomy and 4-Port Laparoscopic Cholecystectomy. Ann Surg 2011; 254:22–27.PubMedCrossRefGoogle Scholar
  12. 12.
    Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev 2006:CD006231.Google Scholar
  13. 13.
    Blinman T Incisions do not simply sum. Surg Endosc 2010; 24:1746–1751.PubMedCrossRefGoogle Scholar
  14. 14.
    Garg P, Thakur JD, Singh I, Nain N, Garima, Gupta V A prospective controlled trial comparing single incision and conventional laparoscopic cholecystectomy: caution before damage control. Surg Laparosc Endosc Percutan Tech 2012 (Accepted, under print).Google Scholar
  15. 15.
    Bignell M, Hindmarsh A, Nageswaran H, et al. Assessment of cosmetic outcome after laparoscopic cholecystectomy among women 4 years after laparoscopic cholecystectomy: is there a problem? Surg Endosc 2011; 25:2574–2577.PubMedCrossRefGoogle Scholar
  16. 16.
    Monkhouse SJ, Court EL, Beard LA, Bunni J, Burgess P A retrospective wound review of standard four-port laparoscopic cholecystectomy: is there need for single-port laparoscopic surgery? Surg Endosc 2012; 26:255–260.PubMedCrossRefGoogle Scholar
  17. 17.
    Garg P, Thakur JD, Raina NC, Mittal G, Garg M, Gupta V Comparison of cosmetic outcome between single-incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy: an objective study. J Laparoendosc Adv Surg Tech A 2012; 22:127–130.PubMedCrossRefGoogle Scholar
  18. 18.
    Pollard JS, Fung AK, Ahmed I Are natural orifice transluminal endoscopic surgery and single-incision surgery viable techniques for cholecystectomy? J Laparoendosc Adv Surg Tech A 2012; 22:1–14.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Pankaj Garg
    • 1
    • 2
    • 5
  • Jai Deep Thakur
    • 3
  • Mahak Garg
    • 1
  • Geetha R. Menon
    • 4
  1. 1.MM Institute of Medical Sciences & ResearchMullanaIndia
  2. 2.Fortis Super Specialty HospitalMohaliIndia
  3. 3.Louisiana State University Health Sciences CenterShreveportUSA
  4. 4.Indian Council of Medical Research (ICMR)New DelhiIndia
  5. 5.PanchkulaIndia

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