title: Prospective randomized comparison of single-incision laparoscopic cholecystectomy with new facilitating maneuver vs. conventional four-port laparoscopic cholecystectomy.
abstract: OBJECTIVE
  We aimed to investigate the technical feasibility of single-incision laparoscopic cholecystectomy (SILC) with our new facilitative maneuver and to compare it with the gold standard four-port laparoscopic cholecystectomy (LC).
  
  
  METHODS
  Operation time, cosmetic score and incisional hernia rates between LC (n=20) and SILC-1 (first 20 consecutive operations with the new technique) and 2 (subsequent 20 operations with the new technique) were compared.
  
  
  RESULTS
  The median operation time for LC, SILC-1 and SILC-2 were; 35 min (12-75), 47.5 min (30-70), and 30 min (12-80), respectively (p=0.005). The operation duration was similar in LC and SILC-2 (p=0.277) groups. Wound seroma rate was higher in SILC-1 (45%) and SILC-2 (30%) groups than LC (5%) group (p=0.010). Cosmetic score was similar between all the groups. Hernia rates were 15.8% and 5.3% in the SILC-1 and SILC-2 groups, respectively, while there was no hernia in the LC group.
  
  
  CONCLUSIONS
  SILC with new facilitating maneuver is comparable with classical four-port laparoscopic cholecystectomy in terms of ease, operation time, reproducibility and safety. Besides these advantages, the single-incision access technique must be optimized to provide comparable wound complication and postoperative hernia rates before being recommended to patients.
authors.affiliation: Clinic of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Aktimur
authors.affiliation: Department of General Surgery, Samsun Private Great Anatolia Hospital, Samsun, Turkey.
authors.forename: Kerim
authors.initials: K
authors.lastname: Güzel
authors.affiliation: Clinic of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Çetinkünar
authors.affiliation: Clinic of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Yıldırım
authors.affiliation: Clinic of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Çolak
keywords: Single-incision; cholecystectomy; conventional; laparoscopic; technique