title: Two-trocar cholecystectomy by strategic laparoscopy for improved cosmesis (SLIC).
abstract: OBJECTIVE
  Until the advent of singleincision laparoscopic surgery, few advances were aimed at improving cosmesis with laparoscopic cholecystectomy. Criticisms of the single-incision laparoscopic surgery technique include a larger incision and increased incidence of wound-related complications. We present our initial experience with a novel technique aimed at performing strategic laparoscopy for improved cosmesis (SLIC) for cholecystectomy.
  
  
  METHODS
  Twenty-five patients with biliary symptoms were selected for SLIC cholecystectomy. Access to the abdomen was obtained with a 5-mm optical trocar in the left upper quadrant and a 5-mm trocar in the umbilicus. Retraction was performed by a transabdominal suture in the dome of the gallbladder and a needlescopic grasper. Age, American Society of Anesthesiologists score, body mass index, operative time, length of stay, pathology results, and short-term complications at follow-up were prospectively recorded.
  
  
  RESULTS
  The 25 female patients had a mean age of 34.3 years and mean body mass index of 24 kg/m(2). American Society of Anesthesiologists scores ranged from 1 to 3. The mean operative time was 51.3 minutes. Pathology revealed chronic cholecystitis in all patients. All procedures were performed on an outpatient basis. The only complication was one ultrasonography-documented deep vein thrombosis. All 25 planned SLIC cholecystectomies were successfully completed.
  
  
  CONCLUSIONS
  SLIC cholecystectomy is feasible and safe. This technique decreases the cumulative incision length, as well as the number of incisions, leading to very desirable cosmetic results in patients with a favorable body habitus and surgical history.
authors.affiliation: Department of Surgery, Akron City Hospital, Center of Excellence, 95 Arch St, Ste 255, Akron, OH 44304, USA; Northeast Ohio Medical University, Rootstown, OH, USA. dana@summahealth.org.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Dan
authors.affiliation: Department of Surgery, Akron City Hospital, Summa Health System, Akron, OH, USA; Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: Shayda
authors.initials: S
authors.lastname: Mirhaidari
authors.affiliation: Department of Surgery, Akron City Hospital, Summa Health System, Akron, OH, USA; Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Pozsgay
authors.affiliation: Department of Surgery, Akron City Hospital, Summa Health System, Akron, OH, USA; Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Standerwick
authors.affiliation: Department of Surgery, Akron City Hospital, Summa Health System, Akron, OH, USA; Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Bohon
authors.affiliation: Department of Surgery, Akron City Hospital, Summa Health System, Akron, OH, USA; Northeast Ohio Medical University, Rootstown, OH, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Zografakis
mesh_terms: D000328:Adult; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D013525:Surgical Instruments; D055815:Young Adult