Skip to main content

Advertisement

SpringerLink
Log in

Transvaginal-hybrid vs. single-port-access vs. ‘conventional’ laparoscopic cholecystectomy: a prospective observational study

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

In the recent past, access to the peritoneal cavity has involved primarily ‘natural orifice transluminal’ and ‘single-port access’ techniques, which are based on laparoscopy. The most frequently performed procedure using these new developments is cholecystectomy. Few studies compare more than one ‘new’ method with the ‘golden standard’ of laparoscopic cholecystectomy. Here we present the results of the first prospective observational study comparing standard laparoscopic cholecystectomy with single-port cholecystectomy as well as transvaginal-hybrid cholecystectomy.

Methods

Fifty-one patients were included in a prospective observational study (20 four-trocar laparoscopic, 15 transvaginal-hybrid, 16 single-port cholecystectomies). Endpoints of the study were operative time, length of hospital stay and postoperative level of pain (numeric analogue score, while coughing). Conversion rates and complications are reported as well.

Results

Median operating times did not differ among all three access methods [55 (35–135) min vs. 65 (35–95) min vs. 68 (35–98) min]. Hospital stay was significantly shorter in the transvaginal-hybrid group [3 (3–12) days] and in the single-port group [3 (1–9) days], compared to the four-trocar laparoscopic group [4 (2–17) days]. Pain score was significantly diminished in the transvaginal-hybrid group during the early postoperative course.

Conclusions

Concerning the length of hospital stay, transvaginal-hybrid cholecystectomy and single-port cholecystectomy appear to be superior to ‘conventional’ laparoscopic cholecystectomy. Additionally, transvaginal-hybrid access is associated with significantly less pain in the early postoperative course.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hagen ME, Wagner OJ, Thompson K et al (2010) Supra-pubic single incision cholecystectomy. J Gastrointest Surg 14:404–407

    Article  PubMed  Google Scholar 

  2. Langwieler TE, Nimmesgern T, Back M (2009) Single-port access in laparoscopic cholecystectomy. Surg Endosc 23:1138–1141

    Article  PubMed  Google Scholar 

  3. Noguera J, Dolz C, Cuadrado A et al (2009) Hybrid transvaginal cholecystectomy, NOTES and minilaparoscopy: analysis of a prospective clinical series. Surg Endosc 23:876–881

    Article  PubMed  Google Scholar 

  4. Rivas H, Varela E, Scott D (2010) Single incision laparoscopic cholecystectomy: initial evaluation of a large series of patients. Surg Endosc 24:1403–1412

    Article  PubMed  Google Scholar 

  5. Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427

    Article  PubMed  Google Scholar 

  6. Reddy N, Rao P (2004) Per oral transgastric endoscopic appendectomy in human. Paper presented at 45th Annual Conference of Gastrointestinal Endoscopy of India, Jaipur, India, 28–29 February 2004

  7. Podolsky ER, Curcillo PG II (2010) Single port access (SPA) surgery—a 24-month experience. J Gastrointest Surg 14:759–767

    Article  PubMed  Google Scholar 

  8. Tacchino RM, Greco F, Matera D et al (2010) Single incision laparoscopic gastric bypass for morbid obesity. Obes Surg. doi:10.1007/s11695-010-0153-8

    Google Scholar 

  9. Curcillo PG II, Wu AS, Podolsky ER et al (2010) Single-port-access (SPA) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc. doi:10.1007/s00464-009-0856-x

    Google Scholar 

  10. DeCarli LA, Zorron R, Branco A et al (2009) New hybrid approach for NOTES transvaginal cholecystectomy: preliminary clinical experience. Surg Innov 16:181–186

    Article  PubMed  Google Scholar 

  11. Dominguez G, Durand L, DeRosa J et al (2009) Retraction and triangulation with neodymium magnetic forceps for single-port laparoscopic cholecystectomy. Surg Endosc 23:1660–1666

    Article  PubMed  Google Scholar 

  12. Edwards C, Bradshaw A, Ahearne P et al (2010) Single-incision laparoscopic cholecystectomy is feasible: initial experience with 80 cases. Surg Endosc. doi:10.1007/s00464-010-0943-z

    Google Scholar 

  13. Hensel M, Schernikau U, Schmidt A et al (2010) Comparison between transvaginal and laparoscopic cholecystectomy—a retrospective case-control study. Zentralbl Chir. doi:10.1055/s-0030-1247332 [German, non-English]

    PubMed  Google Scholar 

  14. Lee SK, You YK, Park JH et al (2009) Single-port transumbilical laparoscopic cholecystectomy: a preliminary study in 37 patients with gallbladder disease. J Laparoendosc Adv Surg Tech A 19(4):495–499

    Article  PubMed  Google Scholar 

  15. Pugliese R, Forgione A, Sansonna F et al (2010) Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases. Langenbecks Arch Surg 395:241–245

    Article  PubMed  Google Scholar 

  16. Romanelli JR, Roshek TB III, Lynn DC et al (2010) Single port laparoscopic cholecystectomy: initial experience. Surg Endosc 24:1374–1379

    Article  PubMed  Google Scholar 

  17. Tsimoyannis EC, Tsimogiannis KE, Pappas-Gogos G et al (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc. doi:10.1007/s00464-010-0887-3

    Google Scholar 

  18. Zornig C, Mofid H, Siemssen L et al (2009) Transvaginal NOTES hybrid cholecystectomy: feasibility results in 68 cases with mid-term follow-up. Endoscopy 41:391–394

    Article  PubMed  CAS  Google Scholar 

  19. Federlein M, Borchert D, Müller V et al (2010) Transvaginal video-assisted cholecystectomy in clinical practice. Surg Endosc 24:2444–2452

    Article  PubMed  Google Scholar 

  20. Linke GR, Tarantino I, Hoetzel R et al (2010) Transvaginal rigid-hybrid NOTES cholecystectomy: evaluation in routine clinical practice. Endoscopy 42:571–575

    Article  PubMed  CAS  Google Scholar 

  21. Keus F, Werner JEM, Gooszen HG et al (2008) Randomized clinical trial of small-incision and laparoscopic cholecystectomy in patients with symptomatic cholecystolithiasis. Arch Surg 143(4):371–377

    Article  PubMed  Google Scholar 

  22. BQS-Qualitätsreport Cholecystectomy (2008) online in internet: http://www.bqs-qualitaetsreport.de/2008/ergebnisse/leistungsbereiche/cholecystectomy/uebersicht [German, non-English]

  23. Erbella JE Jr, Bunch GM (2010) Single-incision laparoscopic cholecystectomy: the first 100 outpatients. Surg Endosc. doi:10.1007/s00464-010-0886-4

    PubMed  Google Scholar 

  24. Bernardes SF, Keogh E, Lima ML (2008) Bridging the gap between pain and gender research: a selective literature review. Eur J Pain 12:427–440

    PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Campus Mitte, Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    Maik Kilian, Wieland Raue, Charalambos Menenakos, Brit Wassersleben & Jens Hartmann

Authors
  1. Maik Kilian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wieland Raue
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charalambos Menenakos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brit Wassersleben
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jens Hartmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maik Kilian.

Additional information

Maik Kilian and Jens Hartmann designed the study. All authors were involved in the acquisition of data. Maik Kilian, Wieland Raue and Jens Hartmann analysed the data. Maik Kilian wrote the manuscript. Wieland Raue and Jens Hartmann revised the manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kilian, M., Raue, W., Menenakos, C. et al. Transvaginal-hybrid vs. single-port-access vs. ‘conventional’ laparoscopic cholecystectomy: a prospective observational study. Langenbecks Arch Surg 396, 709–715 (2011). https://doi.org/10.1007/s00423-011-0769-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-011-0769-8

Keywords

Search

Navigation