Single-incision<i>vs</i>three-port laparoscopic cholecystectomy: Prospective randomized study

Pan, Mingxin; Jiang, Zhiying; Cheng, Yuan; Xu, Xiaoping; Zhang, Zhi; Qin, Jiasheng; He, Guolin; Xu, Ting-Cheng; Zhou, Chengyu; Liu, Haiyan; Gao, Yi

doi:10.3748/wjg.v19.i3.394

Cited by 62 publications

(66 citation statements)

References 18 publications

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“…IAP of all the patients in the present study was maintained at 12 mmHg. Ming-Xin Pan et al [38] , Maria F, et al [7] and many others also used IAP of either 12 mmHg or 13 mm Hg Conversion rate of present study is 1.36%. From time to time, various authors have reported various conversion rate viz.…”

Section: Discussionsupporting

confidence: 49%

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Bhattarai¹,

Sulaimankulov²,

Dangi³

et al. 2016

AIMDR

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Background: Since the introduction of laparoscopic cholecystectomy in 1987 by Philips Mouret its popularity has increased tremendously and very rapidly because of its several advantages. But reports of randomized large control seriesare not yet available so we plan to report our experience of 5000 cases of single incision laparoscopic cholecystectomies and their anesthetic management. Objective: The purpose of this retrospective study was to evaluate the general anesthetic technique for laparoscopic cholecystectomy keeping in mind the pathophysiological effect of laparoscopy, head up position and pneumoperitoneum. Methods: A retrospective study of 5000 cases of symptomatic gall bladder disease that underwent laparoscopic cholecystectomy at Nobel Medical College Teaching Hospital, Nepal from Jan 2010-Dec 2015 was done. Detail pre-anesthetic check up, investigation, preparation and anesthetic techniques were carried out as per hospital protocol. Strict vigil was made to maintain the vital parameters within normal limit particularly ETCO2 below 35 mmHg. All efforts were made to keep ETCO2 below 35mHg. At the end of surgery residual neuromuscular blockade was reversed with neostigmine and glycopyrrolate, before they were transferred to PACU. Results: The mean age of the patients was 48 years with a male:female of 1:2.26. 28.64 % of patients belonged to ASA III. More than 95 % patients maintained SPO2 between 98-100% and 91% maintained their ETCO2 below or around 35 mmHg. Intra-operative surgical and anesthetic complications were controlled with proper therapies. There was no intra-operative death. Conclusion: Single incision laparoscopic Cholecystectomy (SILC) is a safe, cost effective ideal for day care surgery and general anesthesia with controlled mechanical ventilation with oxygen, air, fentanyl, isoflurane, midazolam and vecuronium/atracurium is good choice.

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Section: Discussionsupporting

confidence: 49%

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Bhattarai¹,

Sulaimankulov²,

Dangi³

et al. 2016

AIMDR

View full text Add to dashboard Cite

show abstract

“…Conversion was required in 6 patients of a single study, specifically 4 patients subjected to singleincision surgery with curved instruments and 2 conventional laparoscopic cholecystectomies [33]. Bile leak or subhepatic collection was reported in 5 studies [19,23,27,30,34], with an equal distribution among treatment arms (3 patients in each treatment group and 4 patients in the control group). The diagnosis was made through a drain tube in two studies which provided relevant information [27,34].…”

Section: Outcomes Of Individual Studiesmentioning

confidence: 99%

Single-incision laparoscopic cholecystectomy with curved versus linear instruments assessed by systematic review and network meta-analysis of randomized trials

et al. 2015

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Single-incision laparoscopic cholecystectomy with curved instruments may be associated with an increased level of operative difficulty, as reflected by the need for auxiliary measures for exposure and increased operative time as compared to the use of linear instruments. Current instrumentation requires further improvement, tailored to the features of single-incision laparoscopic surgery (CRD42015015721).

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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: 75%

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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Single-incisionvsthree-port laparoscopic cholecystectomy: Prospective randomized study

Abstract: SILC is a safe and feasible approach in selected patients. The main advantages are a better cosmetic result and less pain.

Cited by 62 publications

References 18 publications

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Single-incision laparoscopic cholecystectomy with curved versus linear instruments assessed by systematic review and network meta-analysis of randomized trials

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

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