Nobumi Tagaya, PhD, Musashi Takada, MD, Shunya Miyazaki, MD, Mayuka Uchida, MD, Natsuki Yamaguchi, MD, Yuhei KHakozaki, MD, Yoshikiyo Matsunaga, MD, Kosuke Hirano, MD, Yoshitake Sugamata, PhD, Masatoshi Oya, PhD. Department of Surgery, Dokkyo Medical University Koshigaya Hospital
Introduction: We herein report our own single-incision laparoscopic cholecystectomy (SILC) technique using several useful devices in order to eliminate the need for extra ports or instruments, and reduce interference between the instruments and the laparoscope.
Patients and methods: We performed SILC in 270 patients, comprising 130 males and 140 females with a mean age of 55 years. Their diagnoses included 250 gallbladder stones, 15 polyps and 5 adenomyomatosis. We made a 2.5-cm longitudinal skin incision at the umbilicus. A wound retractor and a surgical glove or other devices were applied at the incision. We used the three 5-mm ports technique. After retracting the gallbladder upward using an Endo-GrabTM, the cystic duct and artery were divided and identified using pre-bending forceps through the flexible port and laparoscopic coagulating shears (LCS). The cystic artery was dissected using the LCS and the cystic duct was also dissected after clipping. The gallbladder was freed from the liver bed using the LCS, and the specimen was retrieved from the umbilical wound.
Results: There were conversions to open laparotomy in 4 cases (1.5%) and requirement of additional ports in 17 (6.3%). The mean operation time was 85 min. The complications were bile duct injury in one case (0.4%) and pneumothorax in two (0.7%). The mean postoperative hospital stay in completed SILC cases was 3 days.
Conclusion: SILC using a hands-free retraction system, flexible port and pre-bending instruments is a feasible and safe procedure when conducted by experienced surgeons.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78858
Program Number: P107
Presentation Session: Poster (Non CME)
Presentation Type: Poster
