Background
Despite the incremental application of single‐incision laparoscopic cholecystectomy (SILC), this procedure has technical difficulties, including physical disturbance and an unstable surgical view through the small incision; therefore, we introduce the solo SILC (S‐SILC) technique using a laparoscopic scope holder, as a simple, fixed and easy‐to‐perform procedure for an unassisted surgeon.
Methods
We performed a comparative analysis of S‐SILC (n = 566) and conventional three‐incision laparoscopic cholecystectomy (n = 874) performed from January 2013 to December 2016 at multiple centres.
Results
There was no significant difference of operative time between the two groups (P = 0.176); however, S‐SILC showed a higher incidence of intraoperative gallbladder perforation, especially in the initial period (17.0% versus 2.3%, P < 0.001); and shorter post‐operative hospital stay (3.3 ± 1.7 versus 1.9 ± 2.7 days, P < 0.001) than conventional three‐incision laparoscopic cholecystectomy. There were no significant differences in major post‐operative complications between the two groups (P = 0.909) and operation type (P = 0.971) was not a significant risk factor for major post‐operative complications in multivariate analysis.
Conclusion
S‐SILC is a feasible and safe procedure; however, careful selection of surgical candidates is necessary in the early period of the experience with this method.