Clinical results between single incision laparoscopic cholecystectomy and conventional 3-port laparoscopic cholecystectomy: prospective case-matched analysis in single institution

Abstract

PurposeThe aim of our study was to compare single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) with respect to clinical outcomes.MethodsPatients with less than a 28 body mass index (BMI) and a benign gall bladder disease were enrolled in this study. From January 2011 to February 2012, 30 consecutive patients who underwent SILC were compared with 30 patients who underwent CLC during the same period. In this study, all operations were performed by one surgeon. In each group, patient characteristics and perioperative data were collected.ResultsThere was no significant difference in the preoperative characteristics. There was no significant difference in the postoperative laboratory result (alanine aminotransferase, aspartate aminotransferase, and alanine aminotransferase), number of conversion and complication cases, and length of hospital stay. The operation time was significantly longer in the SILC group (78.5 ± 17.8 minutes in SILC group vs. 34.9 ± 5.75 minutes in CLC group, P < 0.0001). The total nonsteroidal antiinflammatory drug usage during perioperative period showed significantly higher in SILC groups (162 ± 51 mg in the SILC group vs. 138 ± 30 mg in the CLC group), but there was no statistically significant difference in opioid usage between two groups. The postoperative pain score was significantly higher in the SILC group at second, third, and tenth postoperative day. Satisfaction of postoperative wound showed superiority in SILC group.ConclusionSILC seems to be an acceptable alternative to CLC with acceptable results. However, it is not enough to propose any real benefits of SILC when compared with CLC in terms of operation time and postoperative pain.

Risk factors for prolonged operative time in single-incision laparoscopic cholecystectomy

“…It is generally known that SILC is a good surgical modality because it has shown better cosmetic outcomes with less postoperative pain as compared with CLC [ 4 5 8 15 ]. A 4-channel SILC might be advantageous in acquiring better operative fields for the exposure of Calot's triangle and liver retraction as compared with a 3-channel one.…”

“…That is, as compared with conventional LC (CLC), SILC is a more advantageous modality in that it causes less postoperative scars and pain. It is disadvantageous, however, in that it prolongs operation time, causes postoperative complications and incurs a higher cost [ 3 4 5 6 7 ]. This limits the applicability of SILC as a standard treatment modality.…”

Dual-incision laparoscopic spleen-preserving distal pancreatectomy

“…Single-port surgery is one such minimally invasive procedures performed for many surgical purposes including appendectomy [8], hernia repair and cholecystectomy [9]. However, only a few surgeons use minimally invasive techniques for pancreatectomy [10].…”

Comparison of Outcomes After Single-Port Laparoscopic Cholecystectomy in Relation to Patient Body Mass Index

“…Thus laparoscopic cholecystectomy has become one of the most frequently performed procedures in visceral surgery. 2 Furthermore, surgical procedures in general are becoming less invasive because of both patient and surgeon preferences for reduced trauma and improved cosmetic outcomes attributable to minimized incisions. The advent of single-port technology in recent years has furthered this trend.…”

“…The advent of single-port technology in recent years has furthered this trend. 2 Accordingly, the results of several studies have shown that single-port laparoscopic cholecystectomy (SPLC) differs significantly from conventional laparoscopic cholecystectomy. Although SPLC has limitations attributable to the highly sophisticated nature of the technique and associated high costs, it also has several advantages over conventional laparoscopic cholecystectomy, such as better cosmetic results, less pain, and faster recovery.…”