Transumbilical single-port laparoscopic cholecystectomy : scarless cholecystectomy.
BACKGROUND
Many laparoscopic surgeons have been attempting to reduce incisional morbidity and improve cosmetic outcomes by using fewer and smaller ports. We performed transumbilical single-port laparoscopic cholecystectomy (TUSPLC) in 15 patients with cholelithiasis by using a special "single-port" with virtually no scar.


METHODS
We used an extra-small wound retractor and a surgical glove as the "single-port." The wound retractor was set up through the small umbilical incision and the surgical glove attached with one trocar and two pipes was then fixed to the outer ring of the wound retractor. The commonly used trocar and two slim pipes attached to the surgical glove served as three working channels. Using this single-port and conventional laparoscopic instruments, such as a straight 5-mm dissector, grasper, scissors, and a 30-degree 5-mm rigid laparoscope, we performed TUSPLC in 15 patients with cholelithiasis. The overall procedure was similar to three-port laparoscopic cholecystectomy.


RESULTS
Fifteen well-selected patients with cholelithiasis underwent TUSPLC (4 males and 11 females; mean age, 39 (range, 29-63) years). Body mass index ranged from 20 to 34 (mean, 25.2). No case required extra-umbilical skin incisions or conversion to standard laparoscopy. The mean operative time was 79 (range, 35-165) min. Blood loss was minimal in all cases. The mean postoperative hospital stay was 1.6 (range, 1.0-2.5) days. No postoperative complications were observed.


CONCLUSIONS
The results of our initial experience of TUSPLC in 15 well-selected patients with cholelithiasis are encouraging. All procedures were completed successfully within a reasonable time. No extra-umbilical incisions were used and virtually no scar remained. TUSPLC could be a promising alternative method for the treatment of some patients with symptomatic gallstone disease as scarless abdominal surgery.
Hong
Tae Ho
TH
Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 665 Bupyung-6-dong, Bupyung-gu, Incheon, 403-720, South Korea.
You
Young Kyoung
YK
Lee
Keun Ho
KH
D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus