Anibal Pimentel, MD, Hely Serrano, MD, Mariana Guerrero, MD, Juan Uribe, MD. CLINICA CHICAMOCHA
Background: Single-port Laparoscopic Cholecystectomy (SPL-C) is a new minimally invasive technique, which has been developed to minimize the surgical access trauma, limiting to one incision which is needed for specimen extraction anyway. The aim of this study was to evaluate the feasibility and security of SPL-C in an ambulatory care setting using standard laparoscopic instruments.
Methods: From April 2012 through July 2016, 436 ambulatory single port laparoscopic Cholecystectomies were performed by a single surgeon using standard laparoscopic instruments. Data were compiled prospectively regarding age, sex, diagnosis, surgical time, ASA, conversion to multiport technique and complications. Diagnosis for cholecystectomy was Chronic Cholecystitis in 75% (CI95% 71,2-79,3) (n=328).
Results: 436 SPL-C procedures were performed using standard laparoscopic instruments, 328 women and 108 men, median age was 43 years old (range, 13 – 81), The median operative time was 32 minutes (range, 20 – 120), ASA score of 1 in 76,6% (CI95% 72,6-80,6); obesity was found in 18,6% (CI95% 14,9-22,2) with median BMI 31 kg/m2 (range 19-40), previous abdominal surgery 59,6% (CI95% 55,0-64,3) (n=260), conversion rate to multiport technique was 3,2% (CI95% 1,5-4,9) (n=14) and there was no conversion to open surgery. Ambulatory setting was feasible in 373 patients (CI95% 82,2-88,9), the main factor for outpatient failure was gallbladder perforation 5,3 % (CI95% 3,2-7,4) (n=23) and there was no readmissions. Minor complications were recorded, the most frequent was wound seroma 2,7% (CI95% 1,2-4,3) (n=12).
Conclusions: ambulatory SPL-C using standard instrumentation is feasible and seems to be safe. Anatomical issues were the main cause to exclude patients from outpatient consideration.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79077
Program Number: P100
Presentation Session: Poster (Non CME)
Presentation Type: Poster
