Expanding the Indications for Single-incision Laparoscopic Cholecystectomy to All Patients With Biliary Disease

Abstract

SILC can be safely offered to patients with a wide spectrum of biliary disease with the understanding that this may result in increased operative times and a higher likelihood of conversion to multiport laparoscopy.

Patient preference matters: cholecystectomy for uncomplicated gallbladder diseases should be performed by single port laparoscopy

“…This suggests, as has already been reflected in the literature, that indications for single port cholecystectomy can be extended to more complex conditions such as acute cholecystitis. 24,25 Our study suggests an advantage in the SP group regarding postoperative pain, reflected in a greater proportion of patients significantly reporting absence of pain when leaving the hospital. This has already been expressed in many papers and, since the other postoperative outcomes remain equal, would favour the single port approach for the treatment of this condition.…”

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

“…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.…”

“…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. Son et al [ 6 ] introduced hand-made ports using ALEXIS wound retractor (Applied Medical) and sterile surgical glove.…”

Single Port Laparoscopic Cholecystectomy: Technical Aspects and Results

“…The search for less traumatic surgical procedures, aesthetically better, without compromising efficacy and safety, together with the technological advances and greater experience of the surgical teams, led to the development of operative techniques with increasingly smaller incisions, the so-called “minimally invasive surgeries” 19 , 22 , 24 , 30 . They are currently the modality of choice for many of the surgical interventions.…”

“…They are currently the modality of choice for many of the surgical interventions. Its benefits are numerous: lesser response to surgical aggression, shorter recovery time and return to personal and professional activities, lower rates of postoperative pain, infections, incisional hernias, as well as smaller and more esthetic operative scars 10 , 18 , 19 , 20 , 22 , 24 , 30 . Minimally invasive operations began in 1909, when Hans C. Jacobaeus performed the first laparoscopy in humans and in 1918, was adopted the use of pneumoperitoneum.…”