Do height and weight affect the feasibility of single-incision laparoscopic cholecystectomy?

Meillat, Hélène; Birnbaum, David; Fara, Régis; Mancini, Julien; Berdah, Stéphane; Bège, Thierry

doi:10.1007/s00464-015-4115-z

Cited by 7 publications

(7 citation statements)

References 40 publications

(51 reference statements)

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“…However, there seems to be varying degrees of difficulty in individual cases. In previous studies, height and BMI were reported as predictive factors for difficult SILC cases , with patients with a higher BMI or taller height had longer operative times. These effects are believed to be due to the longer distance to the target organ .…”

Section: Discussionmentioning

confidence: 93%

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Correlation between port‐to‐target distance and procedural difficulty in single‐incision laparoscopic cholecystectomy: An observational study

Ohira

Shibuya

Uemura

et al. 2018

Asian J Endoscop Surgery

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Introduction: Single-incision laparoscopic cholecystectomy (SILC) is more challenging than conventional (multiport) laparoscopic cholecystectomy (CLC) because of the increased likelihood of instrument collision and the limited surgical workspace. In SILC, procedural difficulties may increase when the port-to-target distance is long. We aimed to assess the correlation between port-to-target distance and procedural difficulty.Methods: Thirty-six consecutive patients who underwent SILC at our hospital were included in this study. The umbilicus-to-Calot's triangle distance (UCD) was measured intraoperatively. The correlations between the UCD and operative time were analyzed, and for comparison, CLC cases during the same period (n = 28) were similarly analyzed. Moreover, UCD was estimated from preoperative CT (UCD-CT), and the usefulness of UCD-CT was assessed during SILC and CLC.Results: Thirty-four patients successfully underwent SILC. There were positive correlations between the UCD and pneumoperitoneum time. Multivariate linear regression analysis, including BMI and height, which were previously reported to have a correlation with longer operative time in SILC, showed that UCD is an independent predictive factor for prolonged operative duration. However, BMI and height were not independent predictive factors. UCD and UCD-CT had a very strong positive correlation; therefore, UCD was estimated from CT. UCD-CT had a strong positive correlation with operative time in SILC, but not in CLC. Conclusions:A longer UCD is an important predictive factor for difficult cases of SILC, but this finding is not applicable in CLC. The usefulness of UCD is specific to SILC. Asian J Endosc Surg 12 (2019) 255-263 NA Data are n (%) or median (interquartile range). CLC, conventional laparoscopic cholecystectomy; LOS, length of hospital stay; NA, not applicable; SILC, single-incision laparoscopic cholecystectomy; UCD, umbilicus-to-Calot's triangle distance; UCD-CT, estimated UCD from preoperative CT.Figure 3 Scatterplots, linear regression models, and Spearman's rank correlation coefficients between UCD and factors of somatotype: (a) height; (b) weight; (c) BMI; and (d) UCD-CT. The gray area of each graph indicates the confidence region for the linear regression. UCD, umbilicus-to-Calot's triangle distance; UCD-CT, estimated UCD from preoperative CT.Figure 5 Scatterplots, linear regression models, and Spearman's rank correlation coefficients between UCD-CT and pneumoperitoneum time in SILC and CLC. The gray area of each graph indicates the confidence region for the linear regression. CLC, conventional laparoscopic cholecystectomy; SILC, single-incision laparoscopic cholecystectomy; UCD-CT, estimated umbilicus-to-Calot's triangle distance from preoperative CT.

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Section: Discussionmentioning

confidence: 93%

“…Previous papers have reported that BMI and height are predictive factors for prolonged operative duration in SILC patients . BMI is also associated with prolonged operative duration in CLC .…”

Section: Introductionmentioning

confidence: 91%

Correlation between port‐to‐target distance and procedural difficulty in single‐incision laparoscopic cholecystectomy: An observational study

Ohira

Shibuya

Uemura

et al. 2018

Asian J Endoscop Surgery

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“…Since Navarra et al [ 3 ] reported SILC in 1997, various multilumen ports that allow simultaneous multiple instrument insertion including the SILS port, ASC Triport (Advanced Surgical Concept, Wicklow, Ireland) and the GelPOINT device, angled or flexible scopes, articulated instruments and instruments of variable length have been introduced [ 4 5 11 ]. Son et al [ 6 ] used a hand-made port for SILC using the ALEXIS wound retractor (Applied Medical) and sterile surgical gloves.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors suggest that the distance between umbilical port and the GB increases with height and obesity [ 14 ]. Consequently, it is more difficult to place the scope and grasper near to the operative field, leading to more struggle and longer operations [ 4 ]. In this study, SILC was very difficult when the distance between umbilicus and rib costal margin was more than 17 cm.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is currently no validated standardized SILC with regard to surgical techniques and device. Meillat et al [ 4 ] used SILS port (Covidien, Mansfield, MA, USA), 10 mm 0° or 30° laparoscope and standard laparoscopic graspers. Beninato et al [ 5 ] used GelPOINT device (Applied Medical, Rancho Santa Margarita, CA, USA) and conventional laparoscopic instruments.…”

Section: Introductionmentioning

confidence: 99%

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One-year experience with single incision laparoscopic cholecystectomy in a single center: without the use of inverse triangulation

et al. 2016

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PurposeSingle incision laparoscopic cholecystectomy (SILC) is generally performed with the use of inverse triangulation. In this study, we performed 3-channel or 4-channel SILC without the use of inverse triangulation. We evaluated the adequacy and feasibility of SILC using our surgical method.MethodsWe retrospectively reviewed our series of 309 SILCs performed between March 2014 and February 2015.ResultsAmong 309 SILCs, male were 148 and female were 161 patients, mean age was 48.7 ± 15.3 years old and mean body mass index was 24.8 ± 3.8 kg/m2. Forty patients had previously undergone abdominal surgery including 6 cases of upper abdominal surgery. SILC after percutaneous transhepatic gallbladder (GB) drainage was completed in 8.7% of cases. There were 10 cases of emergency SILC. SILC was performed for noncomplicated GB including symptomatic GB stone and polyp in 66.7% of cases, acute cholecystitis in 33.3%. Overall, 96.8% of procedures were successfully completed without additional port. The reason for addition of an extra port or open conversion included technical difficulties due to severe adhesion and bleeding. The mean operating time was 60.7 ± 22.3 minutes. The overall complication rate was 4.8%: 9 patients of wound seroma, 1 case of bile leakage from GB bed, 4 cases of intra-abdominal abscess or fluid collection, and 1 case of incisional hernia were developed. There was no case of common bile duct injury.ConclusionOur surgical method of SILC without the use of inverse triangulation is safe, feasible and effective technique.

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Phase II clinical experience and long-term follow-up using the next-generation single-incision platform FMX314

et al. 2015

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Do height and weight affect the feasibility of single-incision laparoscopic cholecystectomy?

Abstract: 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.

Cited by 7 publications

References 40 publications

Correlation between port‐to‐target distance and procedural difficulty in single‐incision laparoscopic cholecystectomy: An observational study

Correlation between port‐to‐target distance and procedural difficulty in single‐incision laparoscopic cholecystectomy: An observational study

One-year experience with single incision laparoscopic cholecystectomy in a single center: without the use of inverse triangulation

Phase II clinical experience and long-term follow-up using the next-generation single-incision platform FMX314

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