The real-world application of single incision laparoscopic cholecystectomy

Park, Hyo Jun; Kim, Dong Hoon; Jeong, Jaehong; Lee, Huisong; Cho, Juhee; Heo, Jin Seok; Choi, Dong Wook; Choi, Seong Ho

doi:10.1016/j.ijsu.2014.09.009

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…21 Park performed 500 SILC and required an additional port in only 1% cases. 22 The conversion rate has been reported to be as high as 16 % where high risk patients were included. 15 The common causes of conversion to FPLC mentioned are inflammation, adhesions, excessive fibrosis and unclear Calot's anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…16 Most of the other studies also by different cosmetic scores reported that cosmesis and patient satisfaction is significantly better with SILC than FPLC. 10,11,15,[20][21][22][23] SILC with conventional laparoscopic instruments is a safe, easily learnable and feasible procedure without additional cost of SILS port and articulated instruments in low risk patients.…”

Section: Discussionmentioning

confidence: 99%

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Comparison between single incision laparoscopic cholecystectomy using conventional laparoscopic instruments vs. four port laparoscopic cholecystectomy in patients of symptomatic cholelithiasis: a prospective randomised study

Gupta

Jhobta

et al. 2023

Int Surg J

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Background: The desire to reduce invasiveness, pain, discomfort and improve cosmesis and early return of patient to normal activities is the basis for single incision laparoscopic surgery. The primary aim was to compare post-operative pain and the secondary aim to compare duration of surgery, intraoperative bile spill or stone spill, duration of hospital stay, any postoperative complications and cosmetic outcome between SILC and the gold standard for symptomatic gall stone disease, FPLC (Four port laparoscopic cholecystectomy). Methods: A total of 150 patients were randomized into two groups, A (SILC) and B (FPLC). Post-operative pain and other intra-operative and post -operative parameters were compared. Results: The age ranged between 20 years to 76 years most of them being females with body mass index ranging between 19 and 35 kg/m2. Comparison of pain score was done using MEWS scale; which was found to be statistically significantly SILC at 6 hours, mean difference (MD)-0.833 while at 24 hours the difference was not significant (MD- 0.234). Duration of surgery was significantly more (MD-12.17 minutes) in SILC. No addition of port or conversion to open cholecystectomy was required. There were no significant difference between post-operative complications between the two groups. Cosmesis was significantly better in terms of look of the scar (MD-0.867) and recommending it to their relatives (MD-0.700) in SILC group. Conclusions: SILC is a safe and easily learnable procedure which can be safely be done using conventional laparoscopic instruments in low risk patients. Duration of surgery even after expertise is gained remains to be more than FPLC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison between single incision laparoscopic cholecystectomy using conventional laparoscopic instruments vs. four port laparoscopic cholecystectomy in patients of symptomatic cholelithiasis: a prospective randomised study

Gupta

Jhobta

et al. 2023

Int Surg J

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“…Mirroring the growth of practice within the adult literature equivalents, single-incision pediatric endoscopic surgery has been increasing in application over a greater variety of cases in children, including in: appendectomy, cholecystectomy, pyloromyotomy, splenectomy, alimentary procedures, gynecological procedures, herniorrhaphy, and pancreatectomy [2,4,22,23,24,25,26,27]. The three SIPES cases above include a cystic lymphatic malformation resection, splenectomy with cholecystectomy, and pancreatectomy with splenectomy.…”

Section: Discussionmentioning

confidence: 99%

Single Incision Pediatric Endoscopic Surgery: From Myth to Reality a Case Series

2019

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Laparoscopic surgery has continued to evolve to minimize access sites and scars in both the adult and pediatric populations. In children, single-incision pediatric endoscopic surgery (SIPES) has been shown to be effective, feasible, and safe with comparative results to multiport equivalents. Thus, the use of SIPES continues over increasingly complex cases, however, conceptions of its efficacy continue to vary greatly. In the present case series and discussion, we review the history of SIPES techniques and its current application today. We present this in the setting of five common myths about SIPES techniques: limitations against complex cases, restrictions to specialized training, increased morbidity outcomes, increased operative lengths, and increased operative costs. Regarding the myth of SIPES being limited in application to simple cases, examples were highlighted throughout the literature in addition to the authors’ own experience with three complex cases including resection of a lymphatic malformation, splenectomy with cholecystectomy, and distal pancreatectomy with splenectomy. A review of SIPES learning curves shows equivalent operative outcomes to multiport learning curves and advancements towards practical workshops to increase trainee familiarity can help assuage these aptitudes. In assessing comorbidities, adult literature reveals a slight increase in incisional hernia rates, but this does not correlate with single-incision pediatric data. In experienced hands, operative SIPES times average approximate multiport laparoscopic equivalents. Finally, regarding expenses, SIPES represents an equivalent alternative to laparoscopic techniques.

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“…Previous studies showed safety and feasibility of SILC with no significant intraoperative complications. [12][13][14] Few studies showed increased rate of intraoperative complications in SILC, but these are statistically insignificant. 15 Operative difficulty, such as compromised vision, insufficient retraction, difficult gallbladder extraction, and difficult instrumentation was noticed significantly higher in SILC.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Single-incision Laparoscopic Cholecystectomy with Four-port Conventional Laparoscopic Cholecystectomy: A Single-center Experience

Goel¹,

Chaubey²,

Gupta³

et al. 2016

WJOLS

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Aims and objective:To assess the feasibility of singleincision laparoscopic cholecystectomy (SILC) with conventional laparoscopic instruments and to compare it with four-port conventional laparoscopic cholecystectomy (LC) regarding various intraoperative and postoperative factors. Materials and methods:This is a prospective randomized controlled study carried out at Santosh Medical College and Hospitals, Ghaziabad from March 2014 to September 2015. This study included 60 patients with cholelithiasis who were divided into two groups of 30 patients each. Group I was offered four-port conventional LC and group II underwent SILC. Results and observations:Cholelithiasis was commonly seen in young females. Single-incision laparoscopic cholecystectomy took more operating time than conventional LC due to more operative difficulty. Outcome of SILC was 79.6% (23 of 30). However, postoperative complications and pain (measured by visual analog scale scoring system) were almost the same in both groups. Cosmetic outcome was better in SILC group. Conclusion:Single-incision laparoscopic cholecystectomy has no added advantage over conventional LC, but it can be performed in selected patients for better cosmetic results.

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The real-world application of single incision laparoscopic cholecystectomy

Abstract: SILC is a safe, effective procedure for cholecystectomy that may be considered the main surgical strategy in select patients.

Cited by 5 publications

References 18 publications

Comparison between single incision laparoscopic cholecystectomy using conventional laparoscopic instruments vs. four port laparoscopic cholecystectomy in patients of symptomatic cholelithiasis: a prospective randomised study

Comparison between single incision laparoscopic cholecystectomy using conventional laparoscopic instruments vs. four port laparoscopic cholecystectomy in patients of symptomatic cholelithiasis: a prospective randomised study

Single Incision Pediatric Endoscopic Surgery: From Myth to Reality a Case Series

Comparative Study of Single-incision Laparoscopic Cholecystectomy with Four-port Conventional Laparoscopic Cholecystectomy: A Single-center Experience

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