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Single-incision and NOTES Cholecystectomy, Are There Clinical or Cosmetic Advantages When Compared to Conventional Laparoscopic Cholecystectomy? A Case–control Study Comparing Single-incision, Transvaginal, and Conventional Laparoscopic Technique for Cholecystectomy

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Abstract

Background

The aim of the present study was to compare the clinical and cosmetic results of transvaginal hybrid cholecystectomy (TVC), single-port cholecystectomy (SPC), and conventional laparoscopic cholecystectomy (CLC). Recently, single-incision laparoscopic surgery and natural orifice transluminal endoscopic surgery have been developed as minimally invasive alternatives for CLC. Few comparative studies have been reported.

Methods

Female patients with symptomatic gallstone disease who were treated in 2011 with SPC, TVC, or CLC were entered into a database. Patients were matched for age, body mass index, and previous abdominal surgery. After the operation all patients received a survey with questions about recovery, cosmesis, and body image.

Results

A total of 90 patients, 30 in each group, were evaluated. Median operative time for CLC was significantly shorter (p < 0.001). There were no major complications. Length of hospital stay, postoperative pain, and postoperative complications were not significantly different. The results for cosmesis and body image after the transvaginal approach were significantly higher. None of the sexually active women observed postoperative dyspareunia.

Conclusions

Both SPC and TVC are feasible procedures when performed in selected patients. CLC is a faster procedure, but other clinical outcomes and complication rates were similar. SPC, and especially TVC, offer a better cosmetic result. Randomized trials are needed to specify the role of SPC and TVC in the treatment of patients with symptomatic gallstone disease.

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References

  1. 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  CAS  PubMed  Google Scholar 

  2. Navarra G, Rando L, La Malfa G et al (2009) Hybrid transvaginal cholecystectomy: a novel approach. Am J Surg 197:e69–e72

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  5. Lee PC, Lo C, Lai PS et al (2010) Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg 97:1007–1012

    Article  PubMed  Google Scholar 

  6. Bucher P, Pugin F, Buchs NC et al (2011) Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br J Surg 98:1695–1702

    Article  CAS  PubMed  Google Scholar 

  7. Tsimoyiannis 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 24:1842–1848

    Article  PubMed  Google Scholar 

  8. van den Boezem PB, Sietses C (2011) Single-incision laparoscopic colorectal surgery, experience with 50 consecutive cases. J Gastrointest Surg 15:1989–1994

    Article  PubMed  Google Scholar 

  9. van den Boezem PB, Kruyt FM, Stommel MW et al (2011) Cholecystectomy without visible scars: the transvaginal method. Ned Tijdschr Geneeskd 155(44):A3617

    PubMed  Google Scholar 

  10. Chow A, Purkayastha S, Aziz O et al (2010) Single-incision laparoscopic surgery for cholecystectomy: an evolving technique. Surg Endosc 24:709–714

    Article  PubMed  Google Scholar 

  11. Strasberg SM, Brunt LM (2010) Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg 211:132–138

    Article  PubMed  Google Scholar 

  12. Dunker MS, Stiggelbout AM, van Hogezand RA et al (1998) Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12:1334–1340

    Article  CAS  PubMed  Google Scholar 

  13. Curcillo PG, Wu AS, Podolsky ER et al (2010) Single-port-access (SPA) cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc 24:1854–1860

    Article  PubMed  Google Scholar 

  14. Kilian M, Raue W, Menenakos C et al (2011) Transvaginal-hybrid vs. single-port-access vs. ‘conventional’ laparoscopic cholecystectomy: a prospective observational study. Langenbecks Arch Surg 396:709–715

    Article  PubMed  Google Scholar 

  15. Voitk AJ, Tsao SG (2001) The umbilicus in laparoscopic surgery. Surg Endosc 15:878–881

    Article  CAS  PubMed  Google Scholar 

  16. Joseph M, Phillips MR, Farrell TM et al (2012) Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg 256:1–6

    Article  PubMed  Google Scholar 

  17. Chow A, Purkayastha S, Dosanjh D et al (2011) Patient reported outcomes and their importance in the development of novel surgical techniques. Surg Innov 19:327–334

    Article  PubMed  Google Scholar 

  18. Bucher P, Pugin F, Ostermann S et al (2011) Population perception of surgical safety and body image trauma: a plea for scarless surgery? Surg Endosc 25:408–415

    Article  PubMed  Google Scholar 

  19. Steinemann DC, Raptis DA, Lurje G et al (2011) Cosmesis and body image after single-port laparoscopic or conventional laparoscopic cholecystectomy: a multicenter double blinded randomised controlled trial (SPOCC-trial). BMC Surg 11:24

    Article  PubMed Central  PubMed  Google Scholar 

  20. Olweny EO, Mir SA, Best SL et al (2011) Importance of cosmesis to patients undergoing renal surgery: a comparison of laparoendoscopic single-site (LESS), laparoscopic and open surgery. BJU Int 110:268–272

    Article  PubMed  Google Scholar 

  21. Lamade W, Friedrich C, Ulmer C et al (2011) Impact of body image on patients’ attitude towards conventional, minimal invasive, and natural orifice surgery. Langenbecks Arch Surg 396:331–336

    Article  PubMed  Google Scholar 

  22. Lind MY, Hop WC, Weimar W et al (2004) Body image after laparoscopic or open donor nephrectomy. Surg Endosc 18:1276–1279

    Article  CAS  PubMed  Google Scholar 

  23. Park SK, Olweny EO, Best SL et al (2011) Patient-reported body image and cosmesis outcomes following kidney surgery: comparison of laparoendoscopic single-site, laparoscopic, and open surgery. Eur Urol 60:1097–1104

    Article  PubMed  Google Scholar 

  24. Durani P, McGrouther DA, Ferguson MW (2009) Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg 62:713–720

    Article  PubMed  Google Scholar 

  25. Bignell M, Hindmarsh A, Nageswaran H et al (2011) Assessment of cosmetic outcome after laparoscopic cholecystectomy among women 4 years after laparoscopic cholecystectomy: is there a problem? Surg Endosc 25:2574–2577

    Article  PubMed  Google Scholar 

  26. Joseph S, Todd Moore B, Brent Sorensen G et al (2011) Single-incision laparoscopic cholecystectomy: a comparison with the gold standard. Surg Endosc 15:3009–3015

    Google Scholar 

  27. Trastulli S, Cirocchi R, Desiderio J et al (2013) Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy. Br J Surg 100:191–208

    Article  CAS  PubMed  Google Scholar 

  28. Zornig C, Siemssen L, Emmermann A et al (2010) NOTES cholecystectomy: matched-pair analysis comparing the transvaginal hybrid and conventional laparoscopic techniques in a series of 216 patients. Surg Endosc 25:1822–1826

    Article  PubMed  Google Scholar 

  29. Bucher P, Ostermann S, Pugin F et al (2011) Female population perception of conventional laparoscopy, transumbilical LESS, and transvaginal NOTES for cholecystectomy. Surg Endosc 25:2308–2315

    Article  PubMed  Google Scholar 

  30. Strickland AD, Norwood MG, Behnia-Willison F et al (2010) Transvaginal natural orifice translumenal endoscopic surgery (NOTES): a survey of women’s views on a new technique. Surg Endosc 24:2424–2431

    Article  PubMed  Google Scholar 

  31. Love KM, Durham CA, Meara MP et al (2011) Single-incision laparoscopic cholecystectomy: a cost comparison. Surg Endosc 25:1553–1558

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Gelderse Vallei Hospital, Willy Brandtlaan 10, Postbus 9025, 6710 HN, Ede, The Netherlands

    Peter B. van den Boezem, Simone Velthuis & Colin Sietses

  2. Department of Anaesthesiology, Gelderse Vallei Hospital, Ede, The Netherlands

    Harm J. Lourens

  3. Department of Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands

    Miguel A. Cuesta

Authors
  1. Peter B. van den Boezem
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  2. Simone Velthuis
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  3. Harm J. Lourens
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  4. Miguel A. Cuesta
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  5. Colin Sietses
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Corresponding author

Correspondence to Peter B. van den Boezem.

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van den Boezem, P.B., Velthuis, S., Lourens, H.J. et al. Single-incision and NOTES Cholecystectomy, Are There Clinical or Cosmetic Advantages When Compared to Conventional Laparoscopic Cholecystectomy? A Case–control Study Comparing Single-incision, Transvaginal, and Conventional Laparoscopic Technique for Cholecystectomy. World J Surg 38, 25–32 (2014). https://doi.org/10.1007/s00268-013-2221-4

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  • DOI: https://doi.org/10.1007/s00268-013-2221-4

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