title: Patient views through the keyhole: new perspectives on single-incision vs. multiport laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Single-incision laparoscopic cholecystectomy (SILC) may be associated with less pain, shorter hospital stay and better cosmetic results than multiport laparoscopic cholecystectomy (MLC). Advocates suggest that patients prefer SILC, although research directly addressing the question of patient preferences is limited. This study aimed to assess patient preferences using currently available evidence.
  
  
  METHODS
  Patients awaiting elective cholecystectomy were shown a series of postoperative images taken after SILC or MLC and asked which procedure this led them to prefer. This was repeated after patients had completed a questionnaire constructed using published objective data comparing patient-reported outcomes of SILC and MLC.
  
  
  RESULTS
  The study was completed by 113 consecutive patients. After their initial viewing of the images, 16% of subjects preferred MLC. Younger age, lower body mass index and female sex were associated with choosing SILC. After completing the questionnaire, 88% of patients preferred MLC (P < 0.001). Patients ranked the level of risk for complications and postoperative pain above cosmetic results in determining their choice of procedure.
  
  
  CONCLUSIONS
  Patients' initial preference when presented with cosmetic appearance was for SILC. When contemporary outcome data were included, the majority chose MLC. This underlines the need to fully inform patients during the consent process and indicates that patient views of SILC may differ from the views of those introducing the technology.
authors.affiliation: Department of Hepatopancreatobiliary Surgery, St James's University Hospital, Leeds, UK. j.d.hey@doctors.org.uk
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hey
authors.forename: Keith John
authors.initials: KJ
authors.lastname: Roberts
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Morris-Stiff
authors.forename: Giles J
authors.initials: GJ
authors.lastname: Toogood
mesh_terms: D022126:Access to Information; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002755:Choice Behavior; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods* / Q000523:psychology*; D002921:Cicatrix / Q000209:etiology; D017558:Elective Surgical Procedures; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D057240:Patient Preference; D010361:Patients / Q000523:psychology*; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult