title: Single incision versus standard 4-port laparoscopic cholecystectomy: a prospective randomized trial.
abstract: BACKGROUND
  Laparoscopy through a single umbilical incision is an emerging technique supported by case series, but prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing single site umbilical laparoscopic cholecystectomy to 4-port laparoscopic cholecystectomy.
  
  
  METHODS
  After IRB approval, patients were randomized to laparoscopic cholecystectomy via a single umbilical incision or standard 4-port access. The primary outcome variable was operative time. Utilizing a power of 0.8 and an alpha of 0.05, 30 patients were calculated for each arm. Patients with complicated disease or weight over 100 kg were excluded. Post-operative management was controlled. Surgeons subjectively scored degree of technical difficulty from 1=easy to 5=difficult.
  
  
  RESULTS
  From 8/2009 through 7/2011, 60 patients were enrolled. There were no differences in patient characteristics. Operative time and degree of difficulty were greater with the single site approach. There were more doses of analgesics used and greater hospital charges in the single site group that trended toward significance.
  
  
  CONCLUSIONS
  Single site laparoscopic cholecystectomy produces longer operative times with a greater degree of difficulty as assessed by the surgeon. There was a trend toward more doses of post-operative analgesics and greater hospital charges with the single site approach.
authors: The Center for Prospective Clinical Trials, The Children's Mercy Hospital, Kansas City, MO, USA. ostlie@surgery.wisc.edu
authors: Daniel J
authors: DJ
authors: Ostlie
authors: Obinna O Adibe David
authors: OO
authors: Juang
authors: Corey W
authors: CW
authors: Iqbal
authors: Susan W
authors: SW
authors: Sharp
authors: Charles L
authors: CL
authors: Snyder
authors: Walter S
authors: WS
authors: Andrews
authors: Ronald J
authors: RJ
authors: Sharp
authors: George W
authors: GW
authors: Holcomb
authors: Shawn D
authors: SD
authors: St Peter
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome