title: The comparison of single incision laparoscopic cholecystectomy and three port laparoscopic cholecystectomy: prospective randomized study.
abstract: OBJECTIVE
  Laparoscopic techniques have allowed surgeons to perform complicated intra-abdominal surgery with minimal trauma. Single incision laparoscopic surgery (SILS) was developed with the aim of reducing the invasiveness of conventional laparoscopy. In this study we aimed to compare results of SILS cholecystectomy and three port conventional laparoscopic (TPCL) cholecystectomy prospectively.
  
  
  METHODS
  In this prospective study, 100 patients who underwent laparoscopic cholecystectomy for gallbladder disease were randomly allocated to SILS cholecystectomy (group 1) or TPCL cholecystectomy (group 2). Demographics, pathologic diagnosis, operating time, blood loss, length of hospital stay, complications, pain score, conversion rate, and satisfaction of cosmetic outcome were recorded.
  
  
  RESULTS
  Forty-four SILS cholesystectomies (88%) and 42 TPCL cholecystectomies (84%) were completed successfully. Conversion to open surgery was required for 4 cases in group 1 and 6 cases in group 2. Operating time was significantly longer in group 1 compared with group 2 (73 minutes vs. 48 minutes; P < 0.05). Higher pain scores were observed in group 1 versus group 2 in postoperative day 1 (P < 0.05). There was higher cosmetic satisfaction in group 1 (P < 0.05).
  
  
  CONCLUSIONS
  SILS cholecystectomy performed by experienced surgeons is at least as successful, feasible, effective and safe as a TPCL cholecystectomy. Surgeons performing SILS should have a firm foundation of advanced minimal access surgical skills and a cautious, gradated approach to attempt the various procedures. Prospective randomized studies comparing single access versus conventional multiport laparoscopic cholecystectomy, with large volumes and long-term follow-up, are needed to confirm our initial experience. (ClinicalTrials.gov Identifier: NCT01772745.).
authors.affiliation: Department of General Surgery, Maltepe University School of Medicine, Istanbul, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Deveci
authors.affiliation: Department of General Surgery, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Barbaros
authors.affiliation: Department of General Surgery, Maltepe University School of Medicine, Istanbul, Turkey.
authors.forename: Mahmut Sertan
authors.initials: MS
authors.lastname: Kapakli
authors.affiliation: Department of General Surgery, Maltepe University School of Medicine, Istanbul, Turkey.
authors.forename: Manuk Norayk
authors.initials: MN
authors.lastname: Manukyan
authors.affiliation: Department of Anesthesiology and Reanimation, Maltepe University School of Medicine, Istanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Simşek
authors.affiliation: Department of General Surgery, Maltepe University School of Medicine, Istanbul, Turkey.
authors.forename: Abut
authors.initials: A
authors.lastname: Kebudi
authors.affiliation: Department of General Surgery, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Mercan
keywords: Cholecystectomy; Laparoscopy; Surgery