title: Single-incision laparoscopic cholecystectomy: do patients care?
abstract: BACKGROUND
  Single-incision approaches to laparoscopic cholecystectomy typically involve increasing the size of the umbilical incision and eliminating three smaller incisions, but it is not intuitive that patients would view this as a benefit. We hypothesize that when patient satisfaction with standard laparoscopic cholecystectomy is assessed, most dissatisfaction will be linked to the umbilical incision and, given the option, patients would actually wish to eliminate this incision.
  
  
  METHODS
  Two hundred eighty-one female patients aged 18 to 40 years who underwent laparoscopic cholecystectomy over a 2-year period were identified, and data were collected on 125 patients.
  
  
  RESULTS
  Fewer than half of patients correctly remembered the number of incisions they had, with 57 patients (45.6%) recalling fewer incisions than were present. Of 58 patients reporting one site to be more painful, 38 (65.5%) cited the umbilical site as the most painful. Eighty-one patients (68.6%) would have preferred to eliminate an incision, with 51 of these (63.0%) choosing to eliminate the umbilical incision.
  
  
  CONCLUSIONS
  As single-incision cholecystectomy enlarges what is already a painful and undesirable incision, and since patients often do not recall the smaller incisions, we should ask ourselves whether surgeons and industry care more about this technique than do the patients to whom we offer it.
authors: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, A100, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors: Kalman P
authors: KP
authors: Bencsath
authors: Gavin
authors: G
authors: Falk
authors: Gareth
authors: G
authors: Morris-Stiff
authors: Matthew
authors: M
authors: Kroh
authors: R Matthew
authors: RM
authors: Walsh
authors: Sricharan
authors: S
authors: Chalikonda
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D017081:Cholecystectomy, Laparoscopic / Q000379:methods / Q000523:psychology*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery; D006801:Humans; D020706:Laparoscopes; D008297:Male; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*; D055815:Young Adult