Single-incision laparoscopic cholecystectomy: a surgeon's initial experience with 56 consecutive cases and a review of the literature.
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.
Roberts
Kurt E
KE
Department of Surgery, Yale University School of Medicine, New Haven, CT, USA. kurt.roberts@yale.edu
Solomon
Daniel
D
Duffy
Andrew J
AJ
Bell
Robert L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020706:Laparoscopes; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010149:Postoperative Pain; D011183:Postoperative Complications / Q000503:physiopathology; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult