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

Abstract

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.

Single-incision laparoscopic cholecystectomy using instrumental alignment in robotic single-site cholecystectomy

“…Although SILC has grown in popularity, it is not yet associated with a standardized technique. Rather, most surgeons use their own procedures, with different instruments and port systems [ 4 5 14 15 16 17 18 ]. Without a standard technique, it is difficult to select the best method when first trying SILC.…”