title: Single-incision laparoscopic cholecystectomy for day surgery procedure: are we prepared?
abstract: Single-incision laparoscopic surgery (SILS) for cholecystectomy is a well-established procedure and represents the next step in developing the concept of fast track surgery. This report describes our experience with SILS cholecystectomy in patients that stay overnight. Between February  2009 and July 2010, patients referred for cholecystectomy to the day surgery unit 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 and the same operative technique was used in  all cases. Postoperative pain and nausea were assessed using a 10-cm visual analogue scale on a self-completion questionnaire on the night of operation and the morning of discharge. A total of 107 patients (58% women, mean age 56 years) with symptomatic gallstones were included in the study.  SILS was successfully performed in all patients and no patient required conversion to an open procedure. There were no significant differences in the median visual analogue scale for postoperative pain and nausea between the night of surgery and the next morning. The mean length of hospital  stay was 23 hours, and 98 per cent of patients were satisfied with the results of surgery and would be willing to undergo the same procedure again. SILS cholecystectomy is a valid alternative to standard laparoscopic cholecystectomy as an outpatient surgery or overnight stay procedure. According  to these promising results, SILS cholecystectomy could be included in a major ambulatory surgery program.
authors.affiliation: General and Endocrine Unit, Department of Digestive Surgery, Digestive Diseases and Metabolism Institute, Hospital Clínic i Provincial, Universitat de Barcelona, Barcelona, Spain. ovidal@clinic.ub.es
authors.forename: Oscar
authors.initials: O
authors.lastname: Vidal
authors.forename: Mihai
authors.initials: M
authors.lastname: Pavel
authors.forename: Mauro
authors.initials: M
authors.lastname: Valentini
authors.forename: Cesar
authors.initials: C
authors.lastname: Ginestà
authors.forename: Josep
authors.initials: J
authors.lastname: Martí
authors.forename: David
authors.initials: D
authors.lastname: Saavedra
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Espert
authors.forename: Guerson
authors.initials: G
authors.lastname: Benarroch
authors.forename: Juan C
authors.initials: JC
authors.lastname: García-Valdecasas
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D020250:Postoperative Nausea and Vomiting; D011446:Prospective Studies; D016896:Treatment Outcome