scholarly journals 8. Single Incision Laparoscopic Surgery for the Digestive Disease Gall Bladder: Single Incision Laparoscopic Cholecystectomy (III)

2011 ◽  
Vol 7 (3) ◽  
pp. 110-112
Author(s):  
Yoshiharu Nakamura ◽  
Yasuo Arima ◽  
Yasuhiro Mamada ◽  
Tsutomu Nomura ◽  
Hiroshi Makino ◽  
...  
Author(s):  
Kirti Savyasacchi Goyal ◽  
Maneshwar Singh Utaal ◽  
Pramod Kumar Bhatia

Background: Laparoscopic cholecystectomy (LC) has evolved to be as gold standard treatment for gall bladder disease and is the most common laparoscopic procedure performed worldwide. In recent times, the innovative techniques of Natural orifice Transluminal Endoscopic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS) have been applied as a step forward towards scar less surgery with added benefits of less pain and less analgesic requirement, shorter hospital stay, quick return to work.Methods: A retrospective study of 50 patients admitted with gall bladder disease through outdoor for laparoscopic cholecystectomy from November 2018 to January 2019 in Maharishi Markandeshwar Institute of Medical Sciences and Research Mullana (AMBALA) were randomized into two groups of  25 each for Single Incision Laparoscopic Cholecystectomy (SILC) and standard laparoscopic cholecystectomy (LC) comparing the operative time, outcome and  complications.Results: 50 patients admitted to MMIMSR Mullana from November 2018 to January 2019 with gall bladder disease were divided into two groups of 25 each who underwent three port SILC and four port laparoscopic cholecystectomy (4PLC). The average intra-operative time in SILC (80.56 mins) was significantly more than standard laparoscopic cholecystectomy. The average length of stay in the hospital for SILC was 1.8 days (1-3 days), was significantly less than in standard four port laparoscopic cholecystectomy. Incidence of Intraoperative complications were more in SILC than standard LC.Conclusions: SILC as the newer novel technique had better outcomes in terms of cosmesis, early discharge, shorter stay at hospital.


2010 ◽  
Vol 49 (179) ◽  
Author(s):  
P B Thapa ◽  
DK Maharjan ◽  
DR Singh

INTRODUCTION: Use of laparoscopic surgery has demanded principles of less trauma of access hence less scar and so probably less complications. Hence conventional laparoscopic surgeries were tried with natural orifice transluminal surgery (NOTES) and then single incision laparoscopic surgery (SILS). With refinement in instruments and surgeons skills SILS have bridged up between conventional and NOTES in order to quench the desire of less or no scar at all. METHODS: Comparative case control study between conventional laparoscopic cholecystectomy and SILS in public teaching hospital. RESULTS: Total 20 patients underwent SILS cholecystectomy and 20 underwent conventional cholecystectomy and found that no difference between both in terms of post operative pain score, hospital stay and post operative wound infection except significant difference in mean operative time and patient's level of satisfaction was less in patient with SILC if were subjected to pay for instruments in order to maintain cosmesis. CONCLUSIONS: Though SILS have gained rapid acceptance in surgical fraternity, large number of randomized controlled trials are necessary to show its benefit over conventional laparoscopic cholecystectomy. Keywords: cholecystectomy, conventional, laparoscopy, single incision, surgery


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Esin Kabul Gürbulak ◽  
Hamdi Özşahin ◽  
Yiğit Düzköylü ◽  
Ismail Ethem Akgün ◽  
Muharrem Battal ◽  
...  

Duplication of the gallbladder is a rare congenital anomaly of the gallbladder, with an estimated prevalence of 1–3 per 3800 individuals. Unless properly diagnosed preoperatively, it can lead to biliary tract injuries and postoperative complications which may require reoperative surgeries. While previously reported cases have been treated with conventional laparoscopic cholecystectomy (LC), treatment with single incision laparoscopic surgery (SILS) has not been reported yet. We herein present the case of a 58-year-old female with gallbladder duplication who was successfully treated with SILS cholecystectomy.


2011 ◽  
Vol 7 (4) ◽  
pp. 148-149
Author(s):  
Satoshi Matsumoto ◽  
Tsutomu Nomura ◽  
Hiroshi Makino ◽  
Hayato Kan ◽  
Yoshiharu Nakamura ◽  
...  

2017 ◽  
Vol 4 (2) ◽  
pp. 514
Author(s):  
Samir Deolekar ◽  
Bhushankumar A. Thakur ◽  
Bhushan Jajoo ◽  
Parnika R. Shinde

Background: Laparoscopic surgery is one of the most significant surgical advances of twentieth century. Laparoscopic cholecystectomy is criterion standard for the treatment of benign gall bladder diseases, and it is the most common laparoscopic surgery worldwide. The aim of the study was to compare the intra-operative and post-operative complication, conversion rate and outcome of single incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy on short term follow up.Methods: This prospective analytical observational design study was carried out in Tertiary Health care centre.  As per convenience sampling 60 consecutive patients of cholelithiasis. Data obtained was analyzed and inferences were drawn regarding the outcomes of the SILC in terms of cosmesis, post-operative pain and any other complications and compare the outcomes against the conventional four port laparoscopic cholecystectomy.Results: In our study we found the mean operating time for SILC was 90.5±16.37 minutes, whereas the mean operating time for CLC was 74±17.83 (p = 0.0004). Intra-operative blood loss for SILC and CLC was comparable and statistically insignificant. Pain in the SILC group was found to be significantly low than CLC group (p ≤0.0001).  The median cosmetic scale score for SILC group was 20 with range 13-21 and in conventional laparoscopic cholecystectomy group it was 16 with range 12-18 (p <0.0001).Conclusions: The major advantage of SILC is cosmetic satisfaction, while the disadvantages of SILS are longer operative time. There was no statistically significant difference in the intra-operative blood loss and conversion rate, and complications in both the techniques. Single incision laparoscopic cholecystectomy (SILC) was developed with the aim of reducing the invasiveness of traditional laparoscopy.


2018 ◽  
Vol 5 (11) ◽  
pp. 3562
Author(s):  
Nagaraj S. Malladad ◽  
Ashwin Kulkarni

Background: Treatment of gall stones have evolved markedly since open cholecystectomy was first described by Lange Buch in 1881. Management has progressed through eras of nonsurgical management, laparotomy, minilaparotomy and now laparoscopic cholecystectomy which is the gold standard for the treatment of gall stone disease today. Laparoscopic surgery is the procedure of choice for most benign gall bladder diseases unless obvious contraindication exists. There has been a trend toward minimizing the required number and size of ports to reduce postoperative pain with better cosmetic results.Methods: Comparative randomized study was conducted in Department of Surgery, SDM College of Medical Sciences and Hospital between February 2017 to July 2018. 60 patients who fit into the inclusion criteria were included in the study. 30 patients were included in the multiport cholecystectomy and 30 in the SILC. Random allocation of patients presenting with symptoms suggestive of gall bladder disease with confirmatory USG study. Group1: single incision laparoscopic cholecystectomy, Group2: multiple port laparoscopic cholecystectomy.Results: Majority of presenting patients were in age group 41-50 years. No significant difference in the mean age of patients, surgical complication, conversion rates and SSI operated by the two techniques. Median time required to complete cholecystectomy by SILC technique was not significantly higher than that required for multiport cholecystectomy. Statistically significant lower postoperative pain score was seen in patients with SILC compared to Multiport laparoscopic cholecystectomy. Patients operated by SILC technique had a postoperative hospital stay of mean 4.04 days, almost same as for patients operated by multiport technique.Conclusions: Difference of Conversion rates and time required for SILC is not significantly higher than that required for multiport cholecystectomy. No rise in intra and post-operative complications occurred in the single port surgery. Postoperative pain is significantly lower in patients undergoing SILC Length of postoperative hospital stay and incidence of SSI for single port cholecystectomy is almost as same as for multiport cholecystectomy.


2020 ◽  
pp. 1-3
Author(s):  
Vinaya Ambore ◽  
Sandeep Darbastwar ◽  
Nikhil Dhimole ◽  
Gurpreet Singh ◽  
Chidananda H

Background Single Incision Laparoscopic Surgery, is an alternative to conventional multi-port laparoscopic surgeries with the aim to reduce complications associated with multiple incisions and increase cosmesis. In this study we aim to compare the single incision approach vs the conventional approach for laparoscopic cholecystectomy. Materials We conducted a prospective cohort study at a tertiary care set up, comparing 30 patients each undergoing conventional laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy. Data recorded included demographics, intra-operative and post-operative course, duration of hospital stay, hospital cost and expenditure. Results We found out that single incision laparoscopic cholecystectomy is associated with longer operative time (65 mins vs 55 mins), a longer hospital stay (5 days vs 2.5 days) and higher hospital expenditure. Intraoperative complications like bleeding and inadvertent gall bladder perforation were more in the single incision group (10% vs 3.3%), and on follow up, 2 patients from the single incision group had surgical site infection and port site herniation compared to none from the conventional laparoscopy group. The patients reported better cosmetic outcome in the single incision laparoscopic cholecystectomy group. Conclusion Single incision laparoscopic cholecystectomy is better than conventional laparoscopic cholecystectomy with regards to final cosmesis and quality of life parameters, however, it comes with higher economic burden, longer operative times and untoward intra-operative and post-operative events.


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