I was intrigued by the article by Wagner et al. [1] in the May 2013 issue of the World Journal of Surgery. The authors’ conclusions, inter alia, state that single-port cholecystectomy results in a better quality of life (QoL) score. This is based on a survey of the 222 patients in the study. Information on QoL is garnered from 131 completed questionnaires. This figure represents 59 % (not 69 %) of the patients. Thus, 91 did not reply or gave inadequate information. This figure is sufficiently large to make the conclusion based on the remaining questionnaires dubious at best.

Furthermore, single-port access (SPA) cholecystectomy was performed by consultant surgeons, whereas the standard laparoscopic approach was used by several surgeons of varying experience, including those below consultant status. The SPA procedure took longer even though performed by senior surgeons. Presumably, if performed by less experienced operators, it would logically take even longer and therefore prove even more expensive. Thus, two planks of the conclusion in the aforesaid article are removed. It therefore appears to be in danger of tottering.