title: Safety and feasibility of single-incision laparoscopic cholecystectomy in obese patients.
abstract: BACKGROUND
  Current literature frequently indicates that experienced laparoscopic surgeons can safely perform single-incision laparoscopic cholecystectomy, but there have been few reports evaluating the feasibility and safety of performing single-incision laparoscopic cholecystectomy for obese patients. Therefore, a large single-center database was retrospectively reviewed to evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy for obese patients by comparing the outcomes of normal-weight and obese patients undergoing single-incision laparoscopic cholecystectomy.
  
  
  METHODS
  A retrospective analysis of 608 patients undergoing SILC between May 2009 and May 2015 at Osaka Police Hospital was performed, and the outcomes of obese [body mass index (BMI) ≥ 30 kg/m2] and normal-weight patients (18.5 ≤ BMI < 25 kg/m2) were compared.
  
  
  RESULTS
  Thirty-eight obese patients (mean BMI 32.5 kg/m2) were compared to 362 normal-weight patients (mean BMI 22.0 kg/m2). The American Society of Anesthesiologists (ASA) scores of the obese patients were significantly higher than those of normal-weight patients. The mean operative times in the normal-weight and the obese groups were 110 min vs. 127 min, respectively (p< 0.05). There were no significant differences in the bleeding volume and the conversion rate to a different operative procedure. Perioperative complications were seen in 6% (23/362) of the patients in the normal-weight group and 8% (3/38) of the patients in the obese group (p= 0.7). The mean postoperative hospital stay was 4.5 days for the normal-weight group and 4.4 days for the obese group (p= 0.8).
  
  
  CONCLUSIONS
  Single-incision laparoscopic cholecystectomy, which offers good cosmetic outcomes, seems feasible and safe in obese patients.
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Wakasugi
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanemura
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Tei
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Furukawa
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Masuzawa
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Akamatsu
keywords: Body mass index; Laparoscopic cholecystectomy; Obesity; Single-incision laparoscopic surgery (SILS)