Single Incision Laparoscopic Cholecystectomy Is Safe and Feasible

Objective: Single incision laparoscopic surgery (SILS) is a new advance wherein laparoscopic surgery is carried out through a single small incision hidden in the umbilicus. Advantages of this technique over standard laparoscopy are still under investigation. The objective of this study is to describe the short term outcomes of SILS cholecystectomies in a single community based institution. Methods: A retrospective review of a prospectively collected database was reviewed on all patients who underwent SILS cholecystectomy. Both true single incision and dual incision (training cases) were included under the ITT principle. Operative and perioperative outcomes were analyzed using standard statistical methods. Results: 32 SILS choles (3 dual incision and 29 single) were performed from 5/30/08 – 10/1/08 (indications: 20 stones, 5 cholecystitis, 7 biliary dyskinesia). Mean BMI was 26 (rng: 18.4 -35.2), mean OR time was 68 mins (rng: 29 – 126), mean EBL was 5cc and mean incision length was 1.6 cm. There were no open conversions but there was one 2 incision and one 4 incision conversion for poor visualization and severe cholecystitis, respectively. Complications include one bile leak managed with ERCP and percutaneous drainage. Mean 10-point pain score prior to discharge was 1.7 (rng: 0 – 7). Number of days of post op oral narcotic use was described as none in 6 pts (31%), minimal (1 day) in 9 pts (47%), moderate (1- 3 d) in 3 pts (16%), and heavy (> 4 d) in 1 pt (5%) with follow up accomplished in 19 of 32 patients to date. Conclusion: SILS cholecystectomy is safe and feasible with acceptable morbidity. Although not directly compared in this study postoperative recovery appears less than standard laparoscopy but more studies are needed.

Session: Podium Presentation

Program Number: S026

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