Skip to main content
SpringerLink
Log in

Single-incision laparoscopic cholecystectomy vs. conventional laparoscopic cholecystectomy: a meta-analysis of the literature

  • original article
  • Published:
European Surgery Aims and scope Submit manuscript

Summary

Introduction

Minimally invasive surgery is gradually becoming the mainstay of surgical treatment. In addition to the current mainstream four-port cholecystectomy, current research has looked upon the possibility of a single-incision laparoscopic cholecystectomy (SILC). In this meta-analysis, we aim to compare conventional multi-port laparoscopic cholecystectomy (CLC) to single-incision laparoscopic cholecystectomy in terms of operative time, cosmesis and postoperative pain.

Materials and methods

A literature search was carried out in PubMed, MEDLINE, EMBASE, and Google Scholar, using the MESH terms ‘randomised controlled trial’, ‘laparoscopy’, ‘single port’, ‘multi-port’ and ‘cholecystectomy’. Randomised controlled trials (RCT) comparing SILC versus CLC published between January 2010 and January 2021 were included. Data were collected on operative time, cosmesis and postoperative pain visual analogue score (VAS) at 6 and 24 h.

Results

Seven randomised controlled trials were used. When compared to CLC, SILC had comparable operative time (chi2 = 273.78; p < 0.00001; CI −2.19, 24.12; I2 = 98%) and VAS pain score at 6 h (chi2 = 19.77; p < 0.0001; CI −0.49, 0.15; I2 = 90%). CLC had a significantly better cosmetic outcome (chi2 = 16.07; p < 0.0003; CI 0.89, 1.38; I2 = 88%). SILC demonstrated a significantly better VAS pain score at 24 h (chi2 = 45.15; p < 0.00001; CI −0.37, −0.02; I2 = 91%).

Conclusion

This meta-analysis demonstrated that except for improved postoperative pain at 24 h, SILC did not show improved outcomes when compared to CLC. With the presently published RCTs, we are unable to provide statistical analysis on further outcomes such as postoperative complications. Hence, the choice of procedure remains largely the decision of the operating surgeon.

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
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Hauters P, Auvray S, Cardin JL, et al. Comparison between single-incision and conventional laparoscopic cholecystectomy: a prospective trial of the Club Coelio. Surg Endosc. 2013;27:1689–94.

    Article  PubMed  Google Scholar 

  2. Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84:695.

    CAS  PubMed  Google Scholar 

  3. Deveci U, Barbaros U, Kapakli MS, et al. The comparison of single incision laparoscopic cholecystectomy and three port laparoscopic cholecystectomy: prospective randomized study. J Korean Surg Soc. 2013;85:275–82.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sharma A, Soni V, Baijal M, et al. Single port versus multiple port Laparoscopic cholecystectomy—A comparative study. Indian J Surg. 2013;75(2):115–22.

    Article  CAS  PubMed  Google Scholar 

  5. Banoria NK, Panwar S, Prakash S, et al. Comparing the operative duration and the pain scores in patients undergoing single port laparoscopic cholecystectomy (SPLC) vs. multiple port laparoscopic cholecystectomy (MPLC). J Evol Med Dent Sci. 2016;5(75):5568–72.

    Article  Google Scholar 

  6. Ganchev G, Saroglu A, Julianov A. Transumbilical laparoscopic cholecystectomy versus standard 4‑port laparoscopic cholecystectomy—Results from prospective randomised trial and 7 years of follow-up. Trakia J Sci. 2020;18(1):97–102.

    Article  Google Scholar 

  7. Klein D, Barutcu AG, Kroll D, et al. Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up. Langenbecks Arch Surg. 2020;405:551–61.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Roy A, Datta PN, Guha K. Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study. Int Surg J. 2020;7(12):3986–93.

    Article  Google Scholar 

  9. Subirana H, Rey FJ, Barri J, et al. Single-incision versus four-port laparoscopic cholecystectomy in an ambulatory surgery setting: A prospective randomised double-blind controlled trial. J Min Access Surg. 2020;17(3):311–7.

    Article  Google Scholar 

  10. Lyu Y, Cheng Y, Wang B, et al. Single-incision versus conventional multiport laparoscopic cholecystectomy: A current meta-analysis of randomised controlled trials. Surg Endosc. 2020;34:4315–29.

    Article  PubMed  Google Scholar 

  11. Evers L, Bouvy N, Branje D, et al. Single-incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy: A systematic review and meta-analysis. Surg Endosc. 2017;31:3437–48.

    Article  PubMed  Google Scholar 

  12. Saad S, Strassel V, Sauerland S. Randomized clinical trial of single-port, minilaparoscopic and conventional laparoscopic chole-cystectomy. Br J Surg. 2013;100(3):339–49.

    Article  CAS  PubMed  Google Scholar 

  13. Abdelrahman AM, Bingener J, Yu D, et al. Impact of single-incision lap-aroscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and work-load: a randomized controlled trial. Surg Endosc. 2016;30(3):1205–11.

    Article  PubMed  Google Scholar 

  14. Arezzo A, Passera R, Bullano A, et al. Multi-port versus single-port cholecystectomy: results of a multi-centre, randomised controlled trial (MUSIC trial). Surg Endosc. 2017;31(7):2872–80.

    Article  PubMed  Google Scholar 

  15. Antoniou SA, Pointer R, Granderath FA. Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc. 2011;25:367–77.

    Article  PubMed  Google Scholar 

  16. Kravetz AJ, Iddings D, Basson MD, et al. The learning curve with single-port cholecystectomy. JSLS. 2009;13:332–6.

    PubMed  PubMed Central  Google Scholar 

  17. Sajid MS, Ladwa N, Kalra L, et al. Single-incision laparoscopic cholecystectomy: Meta-analysis and systematic review of randomised controlled trials. World J Surg. 2012;36:2644–53.

    Article  PubMed  Google Scholar 

  18. Pisanu A, Reccia I, Porceddu G, et al. meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC). J Gastrointest Surg. 2012;16:1790–801.

    Article  PubMed  Google Scholar 

  19. 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;26:1296–303.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Mater Dei Hospital, 1080, Msida, Malta

    Mark Portelli, Samuel Attard & Tonio Bezzina

Authors
  1. Mark Portelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samuel Attard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tonio Bezzina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Portelli.

Ethics declarations

Conflict of interest

M. Portelli, S. Attard and T. Bezzina declare no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Portelli, M., Attard, S. & Bezzina, T. Single-incision laparoscopic cholecystectomy vs. conventional laparoscopic cholecystectomy: a meta-analysis of the literature. Eur Surg 55, 54–59 (2023). https://doi.org/10.1007/s10353-022-00791-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-022-00791-7

Keywords

Search

Navigation