Incisional Hernia Rate May Increase After Single-Port Cholecystectomy

Alptekın, Husnu; Yılmaz, Hüseyin; Acar, Fahrettin; Kafali, Mehmet Ertugrul; Şahi̇n, Mustafa

doi:10.1089/lap.2012.0129

Cited by 76 publications

(40 citation statements)

References 24 publications

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“…Additionally, SPS patients might need to be followed longer in order not to miss incisional hernias. This latter finding was also supported by another study on SPS [10].…”

Section: Discussionsupporting

confidence: 82%

Single Port vs. Four Port Cholecystectomy – Randomized Trial on Quality of Life

Sulu¹,

Yildiz²,

Ilingi³

et al. 2015

Adv Clin Exp Med

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Background. Classical laparoscopic cholecystectomy involves four ports while most novel 'single port' technique only requires one incision on the abdominal wall. This technique is thought to decrease surgical trauma and improve cosmesis although there are reports pointing out that classical laparoscopic cholecystectomy is also feasible in terms of cosmesis. Objectives. In this study we tried to determine if there are certain advantages in quality of life after single port surgery which would justify its utilization instead of classical laparoscopic cholecystectomy. Material and Methods. This is a prospective randomized study which enrolled 30 patients randomized either into classical laparoscopic cholecystectomy or single port surgery. The primary endpoint was patient satisfaction after surgery. This was assessed with short form 36 and gastrointestinal quality of life index (first preoperatively and then 3 months postoperatively) and a visual analogue scale on the first and seventh days. Results. There was not a statistically significant difference between groups in the emotional role, social functions, mental health, vitality and general health subscales of short form 36. At the end of 12 weeks, both groups demonstrated increases in the gastrointestinal and social subscales of the gastrointestinal quality of life index. There was not a statistically significant difference between groups when the visual analogue scale scores on first and seventh days were compared. Conclusions. The equal length of hospitalization, patient quality of life and pain perception and the longer operative times, high likelihood of incisional hernia and surgical site infection call into question the utilization of single port surgery, as it does not seem to confer an advantage over classical laparoscopic cholecystectomy (Adv Clin Exp Med 2015, 24, 3, 469-473).

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“…Additionally, SPS patients might need to be followed longer in order not to miss incisional hernias. This latter finding was also supported by another study on SPS [10].…”

Section: Discussionsupporting

confidence: 82%

Single Port vs. Four Port Cholecystectomy – Randomized Trial on Quality of Life

Sulu¹,

Yildiz²,

Ilingi³

et al. 2015

Adv Clin Exp Med

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“…It has been argued against single port laparoscopy that there could be a higher rate of incisional hernia. [26][27][28][29][30][31] We did not find any such difference, and we actually believe that it is easier to close the fascial wound after single port laparoscopy because the larger skin incision facilitates the closing. Longer follow-up time should in any case be employed to re-evaluate whether incisional hernia rates continue to be equal in both groups.…”

Section: Discussionmentioning

confidence: 64%

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

et al. 2017

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Background: Laparoscopic cholecystectomy for uncomplicated gallbladder diseases (UGD) is a low-complexity procedure with little morbidity. Single port approach (SPA) benefits are unclear. Our aim is to identify any advantages by evaluating both the clinical outcomes of this approach and also patient opinion, following a year of implementation in our institution.Methods: Data from patients operated on during 2015 for UGD by SPA or conventional laparoscopic approach (CLA) were collected. Patients were asked to answer a telephone questionnaire 4-6 months after the operation.Results: 47 patients were operated on by SPA (SP group) and 117 by CLA (CL group). No differences were found between preoperative variables, surgical time, morbidity, length of stay or wound complications. More SP group patients reported no pain at discharge (72.3 vs 54.7%, p=0.037). 138 patients answered the questionnaire. No significant differences were found when comparing overall satisfaction. Wound aspect satisfaction was higher in the SP group (100 vs 80.9%, p=0.001). A higher proportion of CL group patients felt that had they had fewer scars, they would be more satisfied (46.8 vs 9.1%, p <0.001), and 35.1% of them opined that their satisfaction would be greater had they been operated on by SPA. In the multivariate analysis, the only variable associated with maximum overall satisfaction was wound aspect satisfaction.Conclusions: SPA is a valid alternative to CLA for UGD. It should be chosen when available, since it provides equal clinical outcomes, diminishes postoperative pain and is preferred by patients.

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“…According to Alptekin et al, SILC was not superior to traditional laparoscopic cholecystectomy. Technical difficulties such as the inability to work comfortably in the limited anatomical area, the proximity of the trocars, superposition of the instruments, and poor ergonomics were the main reasons stated [5,10]. The results of some clinical studies have also supported this conclusion.…”

Section: Discussionmentioning

confidence: 97%

“…The closed environment of the umbilicus region increases the risk of secretion and infection around the incision in patient groups operated with multi-channel devices. Bunting reports that hernia development is most common in the umbilicus among the trocar insertion sites (88.9%) [5,[22][23][24]. Although actual rates are not known, Alptekin et al found the frequency of port site hernia development after the SILC technique to be about 3.2 times higher than the LC technique [5].…”

Section: Post-operative Complicationsmentioning

confidence: 99%