scholarly journals Single-incision laparoscopic cholecystectomy: Initial experience with different multichannel ports

2012 ◽  
Vol 59 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Zoran Raznatovic ◽  
Nemanja Zaric ◽  
Ljubomir Djurasic ◽  
Nebojsa Lekic ◽  
Vladimir Djordjevic ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Single Incision ◽  
Conventional Laparoscopic ◽  
Minimally Invasive Surgical ◽  
Average Pain ◽  
Average Pain Score ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Cosmetic Effect ◽  
The Mean

Single-incision laparoscopic cholecystectomy is a relatively new minimally invasive surgical technique in treatment of benign gallbladder diseases. It is considered a bridge technique between conventional laparoscopic cholecystectomy (LC) and NOTES. We are presenting our initial experiences in SILC (single-incision laparoscopic cholecystectomy). Seventeen patients underwent SILC (11 women and 6 men) with an average age of 43 years. Mean BMI score was 29,4 kg/m2. The mean operative time was 93,5 minutes. There were conversions to conventional LC in two cases (11,6%). Average pain score measured on visual-analogue scale (VAS) 8h after the operation was 2,00. All patients expressed satisfaction with achieved cosmetic effect. We conclude that SILC is safe and feasible procedure, with excellent cosmetic effect, but further prospective studies are required before SILC can be generally accepted.

Comparison of Single-Incision Laparoscopic Cholecystectomy versus Needlescopic Cholecystectomy: A Single Institutional Randomized Clinical Trial

2018 ◽  
Vol 36 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Akira Umemura ◽  
Takayuki Suto ◽  
Seika Nakamura ◽  
Hisataka Fujiwara ◽  
Fumitaka Endo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Single Incision ◽  
Cosmetic Outcome ◽  
Needlescopic Cholecystectomy ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Vas Scores ◽  
The Mean ◽  
Incisional Pain

Background: Both single-incision laparoscopic cholecystectomy (SILC) and needlescopic cholecystectomy (NSC) are superior to conventional laparoscopic cholecystectomy in terms of cosmetic outcome and incisional pain. We conducted a prospective, randomized clinical trial to evaluate the surgical outcome, postoperative pain, and cosmetic outcome for SILC and NSC procedures. Methods: In this trial, 105 patients were enrolled (52 in the SILC group; 53 in the NSC group). A visual analogue scale (VAS) was used to evaluate the cosmetic outcome and incisional pain for patients. Logistic regression analyses were used to evaluate the operative difficulty that was present for both procedures. Results: There were no significant differences in patient characteristics or surgical outcomes, including operative time and blood loss. The mean VAS scores for cosmetic satisfaction were similar in both groups. There were significant differences in the mean VAS scores for incisional pain on postoperative day 1 (p = 0.009), and analgesics were required within 12 h of surgery (p = 0.007). Obesity (body mass index ≥25 kg/m2) was the only significant influential factor for operating time over 100 min (p = 0.031). Conclusion: NSC is superior to SILC in terms of short-term incisional pain. Experienced laparoscopic surgeons can perform both SILC and NSC without an increase in operative time.

scholarly journals Comparison of single incision laparoscopic cholecystectomy with conventional laparoscopic cholecystectomy using conventional laparoscopic instrument: a prospective observational study

2017 ◽  
Vol 4 (2) ◽  
pp. 514
Author(s):  
Samir Deolekar ◽  
Bhushankumar A. Thakur ◽  
Bhushan Jajoo ◽  
Parnika R. Shinde
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Single Incision ◽  
Operating Time ◽  
Operative Blood Loss ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
The Mean

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.

Retrospective Non-Inferiority Analysis of Comparative of Performance on Single Incision Laparoscopic Cholecystectomy (SILC) between Using a Conventional Equipment and a Commercially Available Equipment

2021 ◽  
Vol 104 (8) ◽  
pp. 1326-1338
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Health Insurance ◽  
Minimally Invasive ◽  
National Health Insurance ◽  
National Health ◽  
Operative Time ◽  
Single Incision ◽  
Surgical Instrument ◽  
Minimally Invasive Surgical ◽  
Single Incision Laparoscopic Cholecystectomy

Background: Single incision laparoscopic cholecystectomy (SILC) is a modern technique for cholecystectomy via a single transumbilical incision. Original surgical equipment including an articulated minimally invasive surgical instrument was necessary for SILC procedures. However, the articulated long length with flexible rotatable tip instrument is expensive and could not be reimbursed by the Thai National Health Insurance. The present study used conventional laparoscopic equipment that is a non-articulated, shorter, and rigid tip to perform SILC. Objective: To compare the effectiveness between conventional and original equipment for the SILC procedure by evaluating the difficulty of SILC indicated by the length of operative time. Materials and Methods: The patients that underwent SILC in Thammasat University Hospital between October 2014 and December 2020 were reviewed from the electronic medical database. The primary outcome was the difficulty of the SILC procedure, determined from the operative time, to evaluate the performance of the SILC procedure between using the conventional or the original equipment in a non-inferiority trial. The secondary outcome was intraoperative and post-operative complications. Results: The eligibility criteria included 592 SILC procedure that was categorized as conventional equipment group with 351 (59.29%) patients and original equipment group with 241 (40.71%) patients. The multivariate analysis reported the number of difficult SILC procedures was less frequent in SILC using conventional equipment when compared with original equipment, significantly with 37 (10.54%) versus 43 (17.84%) relative risk (RR) (1.75, 95% CI 1.081 to 2.822, p=0.023). The intraoperative bile leakage, cystic artery injury, wound infection and 3-months follow-up of incisional hernia were not different in SILC procedures using eithers equipment. Conclusion: The application of conventional equipment that is used in multiple-port LC procedure to perform in SILC procedure was safe and not related to difficulty of SILC. This can reduce the cost of surgery, especially for articulated instrument that cannot be reimbursed from the National Health Insurance in Thailand. Keywords: Laparoscopic cholecystectomy; Single-incision laparoscopic cholecystectomy; Articulated minimally invasive surgical instrument; Difficult laparoscopic cholecystectomy.

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.

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