Early experience in single-site laparoscopic cholecystectomy.
BACKGROUND
Laparoscopic cholecystectomy is currently the gold standard for removal of symptomatic gallbladders. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of single-incision laparoscopic cholecystectomy (SILC). We report our early experience with SILC and assess its feasibility and safety.


METHODS
A prospective study was conducted of the first 100 patients who presented with complaints of biliary colic and underwent laparoscopic cholecystectomy via the single-port technique at our institution. SILC was performed via a single-port device such as a flexible umbilical port that could accommodate up to three surgical instruments. The port was inserted into a transumbilical incision around 15-20 mm long. Data on operative details and postoperative outcomes were collected and evaluated.


RESULTS
The mean operation time was 67.8 minutes. Six patients needed conversion, requiring extra 5-mm ports to complete the surgery. No serious intraoperative complications, such as bile duct injury or bile leakage, were encountered. Cosmesis from the scar hidden within the umbilical fold was excellent.


CONCLUSIONS
Our initial results of single-port laparoscopic cholecystectomy are promising, with no complications being seen in this early series. However, the drawbacks include the higher cost of equipment and a steeper learning curve. Further evaluation is required to assess the risks and benefits of this approach when compared with conventional laparoscopic cholecystectomy.
Department of Surgery, National University Hospital, 1E Kent Ridge Road, Singapore 119228. cfscky@nus.edu.sg
Stephen Kin Yong
SK
Chang
Shaun Shi Yan
SS
Tan
Yee Onn
YO
Kok
D000368:Aged; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods*; D003085:Colic / Q000175:diagnosis / Q000601:surgery; D004867:Equipment Design; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000601:surgery*; D005762:Gastroenterology / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome