title: Single-incision versus standard laparoscopic cholecystectomy: comparison of surgical outcomes from a single institution.
abstract: BACKGROUND
  Laparoscopic cholecystectomy via the three-trocar technique is widely used for symptomatic gallbladder stones. Single-incision laparoscopic surgery (SILS) for cholecystectomy is a well-established procedure and represents the next step in developing the concept of mini-invasive surgery. We here described our 24-month experience SILS cholecystectomy.
  
  
  METHODS
  Between February 2009 and 2011, patients referred for cholecystectomy to the General and Endocrine Unit of our institution who agreed to undergo SILS were included in a prospective study. All operations were performed by the same surgical team specially trained in this type of surgery. The umbilicus was the sole point of entry for all patients. The same operative technique was used in all patients. Data of patients undergoing SILS cholecystectomy were compared with those from an uncontrolled group of patients undergoing standard laparoscopic cholecystectomy during the same study period.
  
  
  RESULTS
  The SILS and standard cholecystectomy groups included 120 patients each. SILS was performed in all patients and none of them required conversion to an open procedure. The median operating time of 45 minutes in the SILS group was not significantly different from that in the standard laparoscopic cholecystectomy group. We suture fascial edge with simple stitches under direct vision, thus reducing the risk of incisional hernia in SILS group (P=.046).
  
  
  CONCLUSIONS
  SILS cholecystectomy was technically feasible and safe and represents a reproducible alternative to standard laparoscopic cholecystectomy in selected patients. The definitive clinical, esthetic, and functional advantages of this technique require further analysis.
authors.affiliation: General and Endocrine Surgery Unit, Department of Digestive Surgery, Digestive Diseases and Metabolism Institute, Hospital Clínic i Provincial, Universitat de Barcelona, IDIBAPS Barcelona, Spain. ovidal@clinic.ub.es
authors.forename: Oscar
authors.initials: O
authors.lastname: Vidal
authors.forename: Mauro
authors.initials: M
authors.lastname: Valentini
authors.forename: Cesar
authors.initials: C
authors.lastname: Ginestà
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Espert
authors.forename: Alberto
authors.initials: A
authors.lastname: Martinez
authors.forename: Guerson
authors.initials: G
authors.lastname: Benarroch
authors.forename: Maria T
authors.initials: MT
authors.lastname: Anglada
authors.forename: Juan C
authors.initials: JC
authors.lastname: García-Valdecasas
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000193:education / Q000379:methods*; D004502:Education, Medical, Continuing; D006801:Humans