Single Port Versus Multiple Port Laparoscopic Cholecystectomy—A Comparative Study

Abstract

Single port laparoscopic cholecystectomy (SPLC) was introduced to minimize postoperative morbidity and improve cosmesis. We performed a comparative study to assess feasibility, safety and perceived benefits of SPLC. Two groups of patients (104 each) with comparable demographic characteristics were selected for SPLC and multiport laparoscopic cholecystectomy (MPLC) between May 2010 to March 2011. SPLC was performed using X cone® with 5 mm extra long telescope and 3 ports for hand instruments. MPLC was performed with traditional 4 port technique. A large window was always created during dissection to obtain the critical view of safety. Data collection was prospective. The primary end points were postoperative pain and surgical complications. Secondary end points were patient assessed cosmesis and satisfaction scores and operating time. The mean VAS scores for pain in SPLC group were higher on day 0 (SPLC 3.37 versus MPLC 2.72, p00.03) and equivalent to MPLC group on day 1(SPLC 1.90 versus MPLC 1.79, p 00.06). Number of patients requiring analgesia for breakthrough pain (SPLC 21.1 % versus MPLC 26.9 %, p00.31) was similar. Number and nature of surgical complications was similar (SPLC 17.3 % versus MPLC 21.2 %, p 00.59). Mean patient assessed cosmesis scores (SPLC 7.96 versus MPLC 7.16, p00.003) and mean patient satisfaction scores (SPLC 8.66 versus MPLC 8.16, p00.004) were higher in SPLC group indicating better cosmesis and greater patient satisfaction.

Comparative Analysis of Immunological Profiles in Women Undergoing Conventional and Single-Port Laparoscopic Cholecystectomy

“…With respect to the mean duration of the surgical procedures, a longer operative time has been reported in the literature for single-port laparoscopic cholecystectomy. Sharma et al 28 compared the mean duration of surgical procedures and found an operative time of 26 min (15-40 min) for multiport laparoscopic cholecystectomy and of 61 min (40-120 min) for single-port laparoscopic cholecystectomy. In the study of Wagner et al 33 , the mean operative time was 60 min (33-190 min) for conventional laparoscopic cholecystectomy and 73 min (35-136 min) for single-port laparoscopic cholecystectomy, with a significant difference between procedures (p<0.001) 33 , 29 , 32 .…”

Single-incision laparoscopic cholecystectomy versus mini-laparoscopic cholecystectomy: A randomized clinical trial study

“…[ 10 ] In other studies, this different was not significant. [ 4 5 ] This difference between the research works may be due to the fact that there might be other reasons other than the port size affecting this matter. The postsurgical effects were not compared between the MLC and the common method.…”

“…The surgery duration of SILC was clearly longer in most of these research works. [ 3 4 5 6 7 8 ] MLC was compared with the common method in a few studies, which indicated that the MLC method did not take a longer time period than the common method.…”

“…[ 11 12 ] On the other hand, the scars of the SILC group looked better in MLC in Lee's study,[ 2 ] SILC method was preferred in most of the studies such as the works of Hosogi, Sasaki, and Sharma in comparison to the common LC regarding the matter of the surgery scar. [ 5 7 9 15 16 17 18 ] The reason behind these statistical differences could be the manner in which the surgeon stiches the skin and not so much the cut length or the port size. Examining this topic would require another research.…”

Prospective randomized comparison of single-incision laparoscopic cholecystectomy with new facilitating maneuver vs. conventional four-port laparoscopic cholecystectomy

“…With the use of single incision laparoscopic cholecystectomy (SILC), this purpose is achieved in terms of cosmetic issues, but its effectiveness in providing minimal postoperative pain is still controversial (2)(3)(4)(5). Recent meta-analysis showed significantly favourable cosmetic benefits, comparable complication rates and length of hospital stay with SILC, but the mean operation time was significantly longer (6).…”