BACKGROUND: We describe the results of a single surgeon's initial experience with single-incision laparoscopic cholecystectomy through his first 56 cases and provide a brief literature review on the development of this technique. METHODS: Through a 2-cm vertical transumbilical incision, three 5-mm ports were placed using the Veress technique. One extracorporeal suture was utilized to provide cephalad retraction of the fundus, and a roticulating instrument grasping the infundibulum provided lateral retraction. The hilum was dissected, and the cystic duct and artery were clipped and divided. One 5-mm port was upgraded to a 10-mm port to allow the introduction of a retrieval bag, and the gallbladder was removed from the abdomen. RESULTS: Of 56 patients, 54 successfully underwent a single-incision laparoscopic cholecystectomy. Two patients required conversion to either a conventional laparoscopic cholecystectomy or open cholecystectomy. The average age was 41 years (18-77) and the average BMI, 30.2 kg/m(2) (18.5-44.6). Mean operative time was 80 min (41-186). Length of stay was 0.3 days (0-2). The complication rate was 3/56 (5.4%). CONCLUSIONS: Our results suggest that single-incision laparoscopic cholecystectomy is a safe and effective alternative to four-port laparoscopic cholecystectomy that provides surgeons with an alternative minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus.
BACKGROUND: We describe the results of a single surgeon's initial experience with single-incision laparoscopic cholecystectomy through his first 56 cases and provide a brief literature review on the development of this technique. METHODS: Through a 2-cm vertical transumbilical incision, three 5-mm ports were placed using the Veress technique. One extracorporeal suture was utilized to provide cephalad retraction of the fundus, and a roticulating instrument grasping the infundibulum provided lateral retraction. The hilum was dissected, and the cystic duct and artery were clipped and divided. One 5-mm port was upgraded to a 10-mm port to allow the introduction of a retrieval bag, and the gallbladder was removed from the abdomen. RESULTS: Of 56 patients, 54 successfully underwent a single-incision laparoscopic cholecystectomy. Two patients required conversion to either a conventional laparoscopic cholecystectomy or open cholecystectomy. The average age was 41 years (18-77) and the average BMI, 30.2 kg/m(2) (18.5-44.6). Mean operative time was 80 min (41-186). Length of stay was 0.3 days (0-2). The complication rate was 3/56 (5.4%). CONCLUSIONS: Our results suggest that single-incision laparoscopic cholecystectomy is a safe and effective alternative to four-port laparoscopic cholecystectomy that provides surgeons with an alternative minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus.
Authors: Sharona B Ross; Jonathan M Hernandez; Steffanie Sperry; Connor A Morton; Michelle Vice; Kenneth Luberice; Alexander S Rosemurgy Journal: J Gastrointest Surg Date: 2011-12-09 Impact factor: 3.452
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Authors: Cori-Ann M Hirai; Daniel Murariu; Matthew D Cooper; Andrew J Oishi; Steven D Nishida; Cedric Sf Lorenzo; Racquel S Bueno Journal: Hawaii J Med Public Health Date: 2013-12
Authors: Muhammad S Sajid; Nikhil Ladwa; Lorain Kalra; Kristian K Hutson; Krishna K Singh; Mazin Sayegh Journal: World J Surg Date: 2012-11 Impact factor: 3.352