title: Do height and weight affect the feasibility of single-incision laparoscopic cholecystectomy?
abstract: BACKGROUND
  Laparoscopic cholecystectomy is the gold standard for gallbladder removal and the most common laparoscopic procedure worldwide. Single-incision laparoscopic surgery has recently emerged as a less invasive potential alternative to conventional three- or four-port laparoscopy. However, the feasibility of single-incision laparoscopic cholecystectomy (SILC) remains unclear, and there are no rigorous criteria in the literature. Identifying patients at risk of failure of this new technique is essential. The aim of our study was to determine risk factors that may predict failure of the procedure.
  
  
  METHODS
  From May 2010 to March 2012, 110 consecutive patients underwent SILC and were reviewed retrospectively. The main feasibility criterion was the procedure failure rate, defined as addition of supplementary port(s) and prolonged (>60 min) operative time. The factors evaluated were age, gender, height, weight, body mass index, previous abdominal surgery, indication for surgery and gallbladder suspension.
  
  
  RESULTS
  There was conversion in 16 patients (14.5%), and the operative time exceeded 60 min for 20 patients (30.9%). Univariate analysis showed a significant independent association between additional port requirement and each of weight as a continuous value, weight ≥80 kg, BMI >26.5 kg/m(2) and height >172 cm. Univariate analysis also showed a significant independent association between prolonged operative duration (>60 min) and each of height and weight as continuous values, height >172 cm and previous abdominal surgery. In the multivariate analysis, only weight remained independently associated with additional port requirement, and height remained independently associated with prolonged operative duration.
  
  
  CONCLUSIONS
  Preoperative identification of the factors increasing the risk of conversion may assist surgeons in making decisions concerning the management of patients, including appropriate use of SILC.
authors.affiliation: Departments of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, 13915, Marseille Cedex 20, France. missh_meillat@yahoo.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Meillat
authors.affiliation: Departments of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, 13915, Marseille Cedex 20, France.
authors.forename: David Jérémie
authors.initials: DJ
authors.lastname: Birnbaum
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, Hôpital La Conception, Aix-Marseille Université, Marseille, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Fara
authors.affiliation: Inserm, IRD, UM 62 SESSTIM, Aix Marseille Université, 13385, Marseille, France.|Public Health Department, APHM, BiosTIC, Hôpital de la Timone, 13385, Marseille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.affiliation: Departments of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, 13915, Marseille Cedex 20, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Berdah
authors.affiliation: Departments of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, 13915, Marseille Cedex 20, France. thierry.bege@ap-hm.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bège
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D001835:Body Weight; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Cholecystectomy; Laparoscopy; Morbidity; Single incision