To compare single incision laparoscopic cholecystectomy with standard laparoscopic cholecystectomy for treatment of symptomatic cholelithiasis: a prospective randomized study

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.

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Re: Single-incision versus 3-port laparoscopic cholecystectomy in symptomatic gallstones: A prospective randomized study

Surgery ◽

10.1016/j.surg.2017.04.004 ◽

2017 ◽

Vol 162 (6) ◽

pp. 1347

Author(s):

Ajay Kumar Pal ◽

Deelip Singh ◽

Abhinav Arun Sonkar ◽

Awanish Kumar

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Incision ◽

Randomized Study ◽

Prospective Randomized Study ◽

Symptomatic Gallstones

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Single-Incision Laparoscopic Cholecystectomy: A Combined Analysis of Resident and Attending Learning Curves at a Single Institution

The American Surgeon ◽

10.1177/000313481207800148 ◽

2012 ◽

Vol 78 (1) ◽

pp. 119-124

Author(s):

Mark Joseph ◽

Michael Phillips ◽

Christopher C. Rupp

Keyword(s):

Laparoscopic Cholecystectomy ◽

Learning Curve ◽

Single Incision ◽

Learning Curves ◽

Patient Specific ◽

Short Learning Curve ◽

Significant Difference ◽

Surgeon Experience ◽

Standard Laparoscopic Cholecystectomy ◽

Single Incision Laparoscopic Cholecystectomy

Single-incision laparoscopic cholecystectomy (SILC) is a recent technical modification on standard laparoscopic cholecystectomy that has been shown to be safe and feasible. Recent studies suggest that experienced laparoscopic surgeons have a short learning curve to become proficient in SILC. However, little is known about the interaction of the learning curves of residents and attending surgeons at academic programs. We prospectively evaluated various metrics of both attending and resident surgeons as they progressed in their experience with SILC. Patients were placed into cohorts of 25 based on teaching surgeon experience. Data recorded included patient-specific and operative variables along with complications, conversion to standard laparoscopic cholecystectomy, and outcomes. One hundred one patients underwent SILC. Twelve per cent of patients required conversion to standard laparoscopic cholecystectomy. No significant difference was found in operative times compared within the experience-based cohorts ( P = 0.21). A reduction in operative time was shown in residents who were proficient in standard laparoscopic cholecystectomy (SLC) along their learning curve. Operative times remained the same for the teaching surgeon regardless of experience of resident surgeon. SILC has a short learning curve for resident surgeons who are proficient in standard laparoscopic surgery. SILC can be effectively taught with few complications and outcomes similar to SLC with preservation of operative efficiency and safety. Further studies are warranted, however, at a national/international level to define the place and use for SILC as well as the incorporation of single-incision techniques into resident curriculum.

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The Pilot Study of Single Incision Laparoscopic Cholecystectomy (SILC) with Standard Laparoscopic Cholecystectomy in Western UP

International Journal of Contemporary Surgery ◽

10.5958/2321-1024.2016.00010.6 ◽

2016 ◽

Vol 4 (1) ◽

pp. 41

Author(s):

Sohan Pal Singh ◽

Akhil Kumar Gupta ◽

Naveen Agarwal ◽

Pulkit Gupta

Keyword(s):

Laparoscopic Cholecystectomy ◽

Pilot Study ◽

Single Incision ◽

Standard Laparoscopic Cholecystectomy ◽

Single Incision Laparoscopic Cholecystectomy

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Initial Experience with Single-Incision Laparoscopic Cholecystectomy

The American Surgeon ◽

10.1177/000313481007600723 ◽

2010 ◽

Vol 76 (7) ◽

pp. 703-707 ◽

Cited By ~ 1

Author(s):

Aaron Carr ◽

Avinash Bhavaraju ◽

John Goza ◽

Russell Wilson

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Incision ◽

Open Cholecystectomy ◽

Biliary Colic ◽

Initial Experience ◽

Low Profile ◽

Female Predominance ◽

Conversion To Open Cholecystectomy ◽

Standard Laparoscopic Cholecystectomy ◽

Single Incision Laparoscopic Cholecystectomy

Single-incision laparoscopic surgical procedures are being developed with the goal of improving cosmesis, reducing postoperative pain, and increasing patient satisfaction. We performed this study to evaluate our initial experience with single-incision laparoscopic cholecystectomy. We used an infraumbilical incision with two upper low-profile 5-mm ports and one lower standard 5-mm port and either a standard 30° Storz laparoscope or an Olympus deflectable tip laparoscope. All patients were followed postoperatively to evaluate the feasibility and outcomes of the procedure. A total of 60 gallbladders were successfully removed by this method (95.2% success rate). Three cases were converted to standard laparoscopic cholecystectomy (4.8% conversion rate) with no conversion to open cholecystectomy. There were no major complications (bile duct injury, liver injury, bowel injury, biliary leak). Median operative time was 51 ± 21 minutes. Diagnoses included cholelithiasis (55%), biliary dyskinesia (32%), biliary colic (13%), and one case of gangrenous cholecystitis. Median patient age was 47 years with a strong female predominance (87%). Our initial experience demonstrates that single-incision laparoscopic cholecystectomy is effective and safe. We are confident that single-incision laparoscopic cholecystectomy is a viable alternative to standard laparoscopic cholecystectomy.

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