• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Prospective Case-control Study of Single-incision Laparoscopic Cholecystectomy in Obese Patients

Toni Beninato, MD, David A Nissan, BS, Filippo Filicori, MD, David A Kleiman, MD, Elliot Servais, MD, Thomas J Fahey Iii, MD, Rasa Zarnegar, MD. New York Presbyterian Hospital – Weill Cornell Medical College

 

Introduction: The objective was to compare surgical outcomes between obese (BMI >30) and non-obese (BMI<30) patients after single-incision laparoscopic cholecystectomy (SILC). A number of observational studies, case series, case controls, and most recently randomized controlled trials have suggested that SILC is a feasible alternative to conventional laparoscopic cholecystectomy. Few articles have investigated the use of SILC on obese patients, and most studies have specifically excluded patients with high BMIs.

Methods and Procedures: This is a prospective study of 72 consecutive patients that underwent SILC by a single surgeon at a tertiary referral center in 2010 and 2011. There were no exclusion criteria. Endpoints included operative time, estimated blood loss, and percent conversion to conventional laparoscopic cholecystectomy. Complication rates were also evaluated. Statistical analysis was done with Student’s t-test or Mann-Whitney U test, where appropriate.

Results: Of the 72 patients who received a SILC, 25 had BMIs greater than 30, with a mean BMI of 37.6 ± 8.3 and a maximum of 63. Mean BMI in non-obese group was 24.8 ± 3.3, with the lowest BMI of 17.3. There were no statistically significant differences between the two groups’ preoperative demographics. Indications for surgery included biliary colic, acute cholecystitis, and gallstone pancreatitis (44.0%, 28.0%, and 24.0% respectively in obese patients vs. 51.1%, 29.8%, and 14.9% in non-obese patients, p=0.52). Obese patients had statistically significantly longer operative times (106.5 ± 32.9 minutes vs. 81.9 ±30.4 minutes, p=0.003), but did not show statistically significant differences in hospital stay (1.65 ± 0.9 days vs. 1.65 ± 1.2 days, p=0.65) or estimated blood loss (median values 10 mL, range 5-300 mL vs. 10 mL, range 5-750 mL p=0.89). Although there was a trend to increased conversion to conventional laparoscopic cholecystectomy in the obese, this was also not found to be significant (12% vs. 4.3% p=0.29). There were no conversions to open cholecystectomy. There was one post-operative bile leak in a non-obese patient with a gangrenous gallbladder. The patient had a stent placed post-operatively and recovered completely. There were no complications in the obesity group.

Conclusions: Obese patients require statistically significantly increased operative times compared to non-obese patients when performing SILC. There were no statistically significant differences in hospital stay, estimated blood loss, conversion rates, or perioperative morbidity. Single-incision laparoscopic cholecystectomy is feasible in obese patients with similar outcomes to non-obese patients and can be performed safely.
 

  Obese (BMI> 30)
n = 25
 
Non-Obese (BMI < 30)
n = 47
 
 
Table 1. Operative statistics for obese vs. non-obese patients undergoing single-incision laparoscopic cholecystectomy.
Indication for Surgery      
Biliary Colic 12 (48.0%) 26 (55.3%)  
Acute Cholecystitis 7 (28.0%) 14 (29.8%) p=0.52
Gallstone pancreatitis 6 (24.0%) 7 (14.9%)  
Operative times (min) 106.5 ± 32.9 81.9 ±30.4 p= 0.003
Hospital stay (days) 1.65 ± 0.9 1.65 ± 1.2 p=0.65
Estimated Blood Loss (mL) 10 mL (range 5-300 mL) 10 mL (5-750 mL) p= 0.89
Conversion to multiple port 3/25 (12%) 2/47 (4.3%) p=0.29

 


Session Number: Poster – Poster Presentations
Program Number: P599
View Poster

169

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons