title: Single-incision laparoscopic cholecystectomy using a flexible endoscope.
abstract: OBJECTIVE
  To describe our experience with a single-incision laparoscopic cholecystectomy (SILC) performed using a flexible endoscope as the means of visualization and surgical dissection. The use of flexible endoscopy in intra-abdominal surgery has never been described.
  
  
  METHODS
  Prospective observational case series.
  
  
  METHODS
  Eleven patients with symptomatic cholelithiasis were selected based on age, clinical presentation, body habitus, and history of previous abdominal surgery. Patients with acute or chronic cholecystitis were excluded.
  
  
  RESULTS
  All procedures were completed laparoscopically via the single umbilical incision without the need to convert to an open operation and without introduction of any additional laparoscopic instruments or trocars. The mean operative time was 149.5 minutes (range, 99-240 minutes). The mean length of hospital stay was 0.36 days. There were no associated intraoperative or postoperative complications.
  
  
  CONCLUSIONS
  In our experience, SILC performed with a flexible endoscope is feasible and safe. Further studies are needed to determine its advantages in reference to postoperative pain and complication rate in juxtaposition with the current standard laparoscopic cholecystectomy.
authors.affiliation: 1090 Amsterdam Ave, Side 10A, New York, NY 10025.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Binenbaum
authors.forename: Julio A
authors.initials: JA
authors.lastname: Teixeira
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Forrester
authors.forename: E John
authors.initials: EJ
authors.lastname: Harvey
authors.forename: John
authors.initials: J
authors.lastname: Afthinos
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Kim
authors.forename: Ninan
authors.initials: N
authors.lastname: Koshy
authors.forename: James
authors.initials: J
authors.lastname: McGinty
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Belsley
authors.forename: George J
authors.initials: GJ
authors.lastname: Todd
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery