Early experience in single-site laparoscopic cholecystectomy

Chang S, Tan S, Kok YO
Correspondence: Dr Stephen Chang Kin Yong, cfscky@nus.edu.sg

ABSTRACT
Introduction Laparoscopic cholecystectomy is currently the gold standard for removal of symptomatic gallbladders. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of single-incision laparoscopic cholecystectomy (SILC). We report our early experience with SILC and assess its feasibility and safety.
Methods A prospective study was conducted of the first 100 patients who presented with complaints of biliary colic and underwent laparoscopic cholecystectomy via the single-port technique at our institution. SILC was performed via a single-port device such as a flexible umbilical port that could accommodate up to three surgical instruments. The port was inserted into a transumbilical incision around 15–20 mm long. Data on operative details and postoperative outcomes were collected and evaluated.
Results The mean operation time was 67.8 minutes. Six patients needed conversion, requiring extra 5-mm ports to complete the surgery. No serious intraoperative complications, such as bile duct injury or bile leakage, were encountered. Cosmesis from the scar hidden within the umbilical fold was excellent.
Conclusion Our initial results of single-port laparoscopic cholecystectomy are promising, with no complications being seen in this early series. However, the drawbacks include the higher cost of equipment and a steeper learning curve. Further evaluation is required to assess the risks and benefits of this approach when compared with conventional laparoscopic cholecystectomy

Keywords: laparoscopic cholecystectomy, minimally invasive, SILC, single-incision surgery, single-port laparoscopy
Singapore Med J 2012; 53(6): 377–380