Single-port-access (SPA) cholecystectomy: a multi-institutional report of the first 297 cases.
BACKGROUND
An important aspect of a new surgical technique is whether it can be performed by other surgeons in other institutions. The authors report the first 297 cases in a multi-institutional and multinational review of laparoscopic cholecystectomy performed via a single portal of entry.


METHODS
Data were collected retrospectively for the initial patients undergoing single-port cholecystectomy by 13 surgeons who performed these procedures in their institutions after training by the authors. The review included operative time, blood loss, incision length, length of hospital stay (LOS), necessary additional trocars, and other parameters important to cholecystectomy. A database of all the single-port-access (SPA) surgeries performed by the surgeons included demographic and procedural details, LOS, complications, and initial follow-up data.


RESULTS
To date, 297 single-port cholecystectomies have been performed for a variety of diagnoses, primarily cholelithiasis. The average operative time was 71 min, and the average LOS was 1-2 days. The average blood loss was minimal. The use of additional port sites outside the umbilicus occurred in 34 of the cases. Of the 35 intraoperative cholangiograms performed, 34 were successful. No significant complications occurred except for seromas and minor postoperative wound infections. These results are comparable with those for standard multiport cholecystectomy. In addition, no access site hernias (ASH) occurred.


CONCLUSIONS
The findings demonstrate that SPA surgery is an alternative to multiport laparoscopy with fewer scars and better cosmesis. One factor affecting the rate for adoption of SPA surgery among other surgeons is the reproducibility of this new procedure. Although this study had insufficient data to determine fully the benefits of SPA surgery, the feasibility of this procedure with safe, acceptable results was demonstrated in this initial large series across multinational institutions.
Department of Surgery, Drexel University College of Medicine, 219 North Broad Street, Philadelphia, PA 19107, USA. paul.curcillo@drexelmed.edu
Paul G
PG
Curcillo
Andrew S
AS
Wu
Erica R
ER
Podolsky
Casey
C
Graybeal
Namir
N
Katkhouda
Alex
A
Saenz
Robert
R
Dunham
Steven
S
Fendley
Marc
M
Neff
Chad
C
Copper
Marc
M
Bessler
Andrew A
AA
Gumbs
Michael
M
Norton
Antonio
A
Iannelli
Rodney
R
Mason
Ashkan
A
Moazzez
Larry
L
Cohen
Angela
A
Mouhlas
Alex
A
Poor
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult