Single-Incision Laparoscopic Cholecystectomy with Conventional Instruments: A Surgeon’s Initial Experience

Abstract

Purpose: Since the early 1990s, laparoscopic cholecystectomy has become the gold standard for cholecystectomy. Single-incision laparoscopic surgery (SILS) is a rapidly evolving field as a bridge between traditional laparoscopic surgery and natural orifice transluminal endoscopic. The results are presented here of a single surgeon’s initial experience with single-incision laparoscopic cholecystectomy with conventional laparoscopic instruments through his first 11 cases. Materials and Methods: A single curved intra-umbilical 25-mm incision was made by pulling out the umbilicus. A 12-mm trocar was placed through an open approach, and the abdominal cavity was explored with a 10-mm laparoscope. One 10-mm and one 5-mm port were inserted laterally from the laparoscope port. Dissection was performed using a dissector, which was not articulated. The gallbladder was investigated with an Endograsper, which was not articulated either. The hilum was dissected, and the cystic duct and artery were clipped and divided. Results: The patients are comprised of 9 females and 2 males with a mean age of 43.3 years and mean body mass index (BMI) of 27.6 kg/m 2 . Open cholecystectomy was not required. The mean operative time was 69.9 min. Length of stay was only one day. All procedures were completed successfully without any perioperative or postoperative complications. In all cases, there was no need to extend the skin incision. Postoperative follow-up did not reveal any umbilical wound complications. The cosmetic results were scored as excellent by all patients. Conclusion: These results suggest that single-incision laparoscopic cholecystectomy is feasible, safe and effective and a promising alternative method to four-port and SILS-port laparoscopic cholecystectomy and as scarless abdominal surgery for the treatment of some patients with gallbladder disease with standard laparoscopic instruments.