scholarly journals A comparative study of single incision laparoscopic cholecystectomy with conventional laparoscopic instruments versus multiple port laparoscopic cholecystectomy

2018 ◽  
Vol 5 (11) ◽  
pp. 3562
Author(s):  
Nagaraj S. Malladad ◽  
Ashwin Kulkarni
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Single Incision ◽  
Single Port ◽  
Postoperative Hospital Stay ◽  
Conversion Rates ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Time Required

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.

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

scholarly journals Comparative study of standard laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy: outcome and complications

2019 ◽  
Vol 7 (11) ◽  
pp. 4310
Author(s):  
Kirti Savyasacchi Goyal ◽  
Maneshwar Singh Utaal ◽  
Pramod Kumar Bhatia
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Operative Time ◽  
Gall Bladder Disease ◽  
Single Incision ◽  
Intraoperative Complications ◽  
Single Incision Laparoscopic Surgery ◽  
Bladder Disease ◽  
Standard Laparoscopic Cholecystectomy ◽  
Single Incision Laparoscopic Cholecystectomy

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.

Single Incision Laparoscopic Cholecystectomy Performed via the “Marionette” Technique Shows Equivalence in Outcome and Cost to Standard Four Port Laparoscopic Cholecystectomy in a Selected Patient Population

2015 ◽  
Vol 81 (10) ◽  
pp. 1015-1020 ◽  
Author(s):  
Maryam N. Saidy ◽  
Sunal S. Patel ◽  
Mark W. Choi ◽  
Mohammed Al-Temimi ◽  
Deron J. Tessier
Keyword(s):  
Multivariate Analysis ◽  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Single Incision ◽  
Univariate Analysis ◽  
Operating Time ◽  
Complication Rates ◽  
Single Incision Laparoscopic Cholecystectomy

The aim of our study is to compare single incision laparoscopic cholecystectomy (SILC) performed using the “marionette” technique (m-SILC), to the standard four-port technique [four-port laparoscopic cholecystectomy (4PLC)]. Patient information was extracted from a prospectively maintained database (n = 188). Our primary endpoint was operative costs (determined by operating time and instruments used). Secondary endpoints were length of stay, operative time, blood loss, and postoperative complication rates. Univariate and adjusted multivariate analysis was used to compare the outcomes. There were a total of 188 patients for this study. Gender, body mass index, American Society of Anesthesiologists class, and resident participation were similar. Patients undergoing m-SILC were younger (43.8 vs 49.8 years old), less likely to have cholangiogram (32% vs 54%), and were more likely to undergo cholecystectomy for chronic cholecystitis (73.3% vs 52%). In univariate analysis, cholecystectomy performed by the “marionette method” as compared with the 4PLC was associated with shorter operative time (67 vs 59 minutes respectively) and shorter hospital stay (1.2 vs 2.08 days respectively). In multivariate analysis, SILC was associated with shorter hospital stay and comparable operative time, blood loss, and postoperative complications. Instrumentation cost was less in SILC (by $94). SILC done by an experienced surgeon with the “marionette” technique on a carefully selected population shows a statistically significant cost benefit while maintaining clinically comparable outcomes to the standard 4PLC.

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