BACKGROUND: Single-incision laparoscopic surgery is now increasingly used as an approach for cholecystectomy, based on anecdotal reports of decreased pain, reduced need for hospitalization, and a better cosmetic result. This is a report of a single surgeon's (JKE) initial experience with single-incision laparoscopic cholecystectomy (SILC). STUDY DESIGN: We collected concurrent data on 238 consecutive patients undergoing SILC by 1 surgeon in a community hospital over 12 months. RESULTS: From June 2008 to June 2009, 238 consecutive patients underwent an attempted SILC for biliary colic or dyskinesia (75%) or acute cholecystitis (25%) by a single surgeon. Conversion to a standard laparoscopic cholecystectomy was necessary in 6 patients (2.5%) for inflammation or bleeding (n = 4) or short cystic duct (n = 2). Conversion to an open cholecystectomy was necessary in 1 patient (0.42%) for a short cystic duct. No injuries to the common bile duct occurred, the average operative time was 40 minutes, and 95% of patients (n = 226) were discharged home on the day of operation. Postoperative port site hematomas occurred in 3 patients (1.3%), and dehiscence of the umbilical skin incision in 2 (0.8%). No perioperative deaths occurred. CONCLUSIONS: This initial experience with SILC documents that the results of the procedure are equivalent to those with the standard procedure using 4 widely-spaced ports when performed by an experienced laparoscopic surgeon. Randomized trials will be necessary to document the suggested benefits of decreased pain and shorter hospitalization. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Single-incision laparoscopic surgery is now increasingly used as an approach for cholecystectomy, based on anecdotal reports of decreased pain, reduced need for hospitalization, and a better cosmetic result. This is a report of a single surgeon's (JKE) initial experience with single-incision laparoscopic cholecystectomy (SILC). STUDY DESIGN: We collected concurrent data on 238 consecutive patients undergoing SILC by 1 surgeon in a community hospital over 12 months. RESULTS: From June 2008 to June 2009, 238 consecutive patients underwent an attempted SILC for biliary colic or dyskinesia (75%) or acute cholecystitis (25%) by a single surgeon. Conversion to a standard laparoscopic cholecystectomy was necessary in 6 patients (2.5%) for inflammation or bleeding (n = 4) or short cystic duct (n = 2). Conversion to an open cholecystectomy was necessary in 1 patient (0.42%) for a short cystic duct. No injuries to the common bile duct occurred, the average operative time was 40 minutes, and 95% of patients (n = 226) were discharged home on the day of operation. Postoperative port site hematomas occurred in 3 patients (1.3%), and dehiscence of the umbilical skin incision in 2 (0.8%). No perioperative deaths occurred. CONCLUSIONS: This initial experience with SILC documents that the results of the procedure are equivalent to those with the standard procedure using 4 widely-spaced ports when performed by an experienced laparoscopic surgeon. Randomized trials will be necessary to document the suggested benefits of decreased pain and shorter hospitalization. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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
Authors: Eun Jung Koo; Soon Hwa Youn; Yang Hyun Baek; Young Hoon Roh; Hong Jo Choi; Young Hoon Kim; Ghap Joong Jung Journal: J Korean Surg Soc Date: 2012-02-27
Authors: Sigi Joseph; B Todd Moore; G Brent Sorensen; John W Earley; Fengming Tang; Phil Jones; Kimberly M Brown Journal: Surg Endosc Date: 2011-04-13 Impact factor: 4.584