Single-incision multiport laparoendoscopic (SIMPLE) surgery: early evaluation of SIMPLE cholecystectomy in a community setting.
BACKGROUND
Conventional Laparoscopic Cholecystectomy (LC) is a safe, established procedure for gallbladder disease. This is usually performed through three to four small incisions. Although postoperative pain is minimal, there still exists some discomfort from multiple incisions. In theory, fewer incisions or incisionless surgery may decrease postoperative morbidity more than that already exists. Reports of microport instrumentation as well as normal orifice translumenal endosurgery (NOTES) cholecystectomy transvaginally, transcolonically, or transgastrically have recently surfaced. However, these require a different skill set and new technology, which is still in its developmental infancy. Single incision surgery has recently entered the minimally invasive arena.


METHODS
Ten consecutive patients requiring laparoscopic cholecystectomy were performed with a single incision multiport technique as described below.


RESULTS
All ten patients had a successful completion of a single incision multiport laparoendoscopic cholecystectomy without need for conversion to two, three, or four incisions. There were no complications and the recovery was comparable to a conventional LC.


CONCLUSIONS
We describe here a single incision multiport laparoendoscopic cholecystectomy (SIMPLE cholecystectomy) technique that is safe for the patient, reproducible, easy to learn, and uses commonly available instruments already in most operating rooms. Conversion, if required, is placement of the remaining two to three ports for a more conventional LC.
Petrotos
Athanassios C
AC
Department of Surgery, Greenwich Hospital, 77 Lafayette Place, Greenwich, CT 06830, USA.
Molinelli
Bruce M
BM
D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006764:Hospitals, Community; D006801:Humans; D020706:Laparoscopes; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000503:physiopathology; D018570:Risk Assessment; D012494:Sampling Studies; D013997:Time Factors; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*; D055815:Young Adult