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Single Port Access Laparoscopic Cholecystectomy (with video)

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Abstract

Background

Single port access (SPA) surgery is a rapidly evolving field due to the complexity of NOTES (natural orifice translumenal endoscopic surgery). SPA combines the cosmetic advantage of NOTES and possibility to perform surgical procedure with standard laparoscopic instruments. We report a technique of umbilical SPA cholecystectomy using standard laparoscopic instruments and complying with conventional surgical principle and technique of minimally invasive cholecystectomy.

Methods

Preliminary, prospective experience of SPA cholecystectomy in 11 patients (median age, 46 (range, 27–63) years) scheduled for cholecystectomy was evaluated. Diagnoses for cholecystectomy were: symptomatic gallbladder lithiasis (n = 7), previous acute cholecystitis (n = 3), and biliary pancreatitis (n = 1).

Results

SPA cholecystectomy was feasible in all patients (median body mass index, 24 (range, 20–34) kg/m2) who were scheduled for preliminary experience using conventional laparoscopic instruments. Median operative time was 52 (range, 40–77) minutes. Intraoperative cholangiography was performed in all patients, except one, and was considered normal. No peroperative or postoperative complications were recorded. Median hospital stay was less than 24 h.

Conclusions

SPA cholecystectomy is feasible and seems to be safe when performed by experienced laparoscopic surgeons using standard laparoscopic instrumentation. SPA cholecystectomy may be safer than the NOTES approach at this time. It has to be determined whether this approach would benefit patients, other than cosmesis, compared with standard laparoscopic cholecystectomy.

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References

  1. Kreus F, Werner J, Gooszen H et al (2008) Randomized clinical trial of small-incision and laparoscopic cholecystectomy in patients with symptomatic cholecystolithiasis. Arch Surg 143:371–377

    Article  Google Scholar 

  2. Purkayastha S, Tilney H, Georgiou P et al (2007) Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a meta-analysis of randomised control trials. Surg Endosc 21:1294–1300

    Article  PubMed  Google Scholar 

  3. Novitsky Y, Kercher K, Czerniach D et al (2005) Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg 140:1178–1183

    Article  PubMed  Google Scholar 

  4. Yuan R, Lee W, Yu S (1997) Mini-laparoscopic cholecystectomy: a cosmetically better, almost scarless procedure. J Laparoendosc Adv Surg Tech A 7:205–211

    Article  PubMed  CAS  Google Scholar 

  5. Lomanto D, De Angelis L, Ceci V et al (2001) Two-trocar laparoscopic cholecystectomy: a reproducible technique. Surg Laparosc Endosc Perctan Tech 11:248–251

    Article  CAS  Google Scholar 

  6. Ramachandran C, Arora V (1998) Two-port laparoscopic cholecystectomy: an innovative new method for gallbladder removal. J Laparoendosc Adv Surg Tech A 8:303–308

    Article  PubMed  CAS  Google Scholar 

  7. Varadarajulu S, Tamhane A, Drelichman E (2008) Patient perception of natural orifice transluminal endoscopic surgery as a technique for cholecystectomy. Gastrointest Endosc 67:854–860

    Article  PubMed  Google Scholar 

  8. Li W, Xiao J (2008) Investigation for acceptance of natural orifice translumenal endoscopic surgery by inpatients with digestive disease. Gastrointest Endosc 67:AB120

    Article  Google Scholar 

  9. Bucher P, Pugin F, Morel P et al (2008) Scarless surgery: myth or reality through NOTES? Rev Med Suisse 4:1550–1552

    PubMed  CAS  Google Scholar 

  10. Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016

    Article  PubMed  Google Scholar 

  11. Kaouk J, Haber G, Goel R et al (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6

    Article  PubMed  Google Scholar 

  12. Forgione A, Maggioni D, Sansonna F et al (2008) Transvaginal endoscopic cholecystectomy in human beings: preliminary results. J Laparoendosc Adv Surg Tech A 18:345–351

    Article  PubMed  Google Scholar 

  13. Zorron R, Maggioni L, Pombo L et al (2008) NOTES transvaginal cholecystectomy: preliminary clinical application. Surg Endosc 22:542–547

    Article  PubMed  CAS  Google Scholar 

  14. Zornig C, Mofid H, Emmermann A et al (2008) Scarless cholecystectomy with combined transvaginal and transumbilical approach in a series of 20 patients. Surg Endosc 22(6):1427–1429

    Google Scholar 

  15. Bessler M, Stevens P, Milone L et al (2008) Transvaginal laparoscopic cholecystectomy: laparoscopically assisted. Surg Endosc 22(7):1715–1716

    Google Scholar 

  16. Scott D, Tang S, Fernandez R et al (2007) Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments. Surg Endosc 21:2308–2316

    Article  PubMed  Google Scholar 

  17. Marescaux J, Dellemagne B, Perretta S et al (2007) Surgery without scars: report of transluminal cholecystectomy in human being. Arch Surg 142:823–826

    Article  PubMed  Google Scholar 

  18. Bucher P, Pugin F, Morel P (2008) Minimally invasive necrosectomy for infected necrotizing pancreatitis. Pancreas 36:113–119

    Article  PubMed  Google Scholar 

  19. Ponsky J, Cherullo E, Sawyer M et al (2008) Single access site laparoscopic radical nephrectomy: initial clinical experience. J Endourol 22:663–666

    Article  PubMed  Google Scholar 

  20. Pearl J, Ponsky J (2007) Natural orifice translumenal endoscopic surgery: a critical review. J Gastrointest Surg 12(7):1293–1300

    Google Scholar 

  21. Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic radical left colectomy in humans. Dis Colon Rectum (in press)

  22. Kaouk J, Palmer J (2008) Single-port laparoscopic surgery: initial experience in children for varicelectomy. BJU Int 102(1):97–99

    Google Scholar 

  23. Desai M, Rao P, Aron M et al (2008) Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int 101:83–88

    Article  PubMed  Google Scholar 

  24. Ates O, Hakguber G, Olguner M et al (2007) Single-port laparoscopic appendectomy conducted intracorporeally with the aid of a transabdominal sling suture. J Pediatr Surg 42:1071–1074

    Article  PubMed  Google Scholar 

  25. Navarra G, Ascanelli S, Sortini D et al (2002) Laparoscopic transabdominal suspension suture. Surg Endosc 16:1378

    Article  PubMed  CAS  Google Scholar 

  26. Gigot J (2007) Bile duct injury during laparoscopic cholecystectomy. J Chir 144:383–384

    Article  Google Scholar 

  27. Keus F, De Jong J, Gooszen H et al (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev 2006 Oct 18; CD006231

  28. Cuesta M, Berends F, Veenhof A (2008) The “invisible cholecystectomy”: a transumbilical laparoscopic operation without a scar. Surg Endosc 22:1211–1213

    Article  PubMed  Google Scholar 

  29. Navarra G, Ascanelli S, Sortini D et al (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  30. ASGE, SAGES (2006) ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery White Paper 2005 Gastrointest Endosc 63:199–203

  31. Palanivelu C, Rajan P, Ranqarajan M et al (2008) Transumbilical flexible endoscopic cholecystectomy in humans: first feasibility study using hybrid technique. Endoscopy 40:428–431

    Article  PubMed  CAS  Google Scholar 

  32. Pomp A (2008) Notes on NOTES: the emperor is not wearing any clothes. Surg Endosc 22:283–284

    Article  PubMed  Google Scholar 

  33. Aftinos J, Forrester G, Binenbaum S et al (2008) Single incision laparoscopic cholecystectomy using flexible endoscopy: saline infiltration gallbladder fossa dissection technique. SAGES abstract book 325

  34. Osborne D, Boe B, Rosemurgy A et al (2005) Twenty-millimeter laparoscopic cholecystectomy: fewer ports results in less pain, shorter hospitalization, and faster recovery. Am Surg 71:298–302

    PubMed  Google Scholar 

  35. Nickkholgh A, Soltaniyekta S, Kalbasi H (2006) Routine versus selective intraoperative cholangiography during laparoscopic cholecystectomy: a survey of 2130 patients undergoing laparoscopic cholecystectomy. Surg Endosc 20:868–874

    Article  PubMed  CAS  Google Scholar 

  36. Ludwig K, Bernhardt J, Lorenz D (2002) Value and consequences of routine intraoperative cholangiography during cholecystectomy. Surg Laparosc Endosc Perctan Tech 12:154–159

    Article  Google Scholar 

  37. Buess G, Cuschieri A (2007) Raising our heads above the parapet: ES not NOTES. Surg Endosc 21:835–837

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Surgery, University Hospital Geneva, 24 rue Micheli-du-Crest, 1211, Geneva, Switzerland

    Pascal Bucher, François Pugin, Nicolas Buchs, Sandrine Ostermann, Fadi Charara & Philippe Morel

Authors
  1. Pascal Bucher
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  2. François Pugin
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  3. Nicolas Buchs
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  4. Sandrine Ostermann
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  5. Fadi Charara
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  6. Philippe Morel
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Corresponding author

Correspondence to Pascal Bucher.

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Bucher, P., Pugin, F., Buchs, N. et al. Single Port Access Laparoscopic Cholecystectomy (with video). World J Surg 33, 1015–1019 (2009). https://doi.org/10.1007/s00268-008-9874-4

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