Swee H Teh, MD, David Mcaslister. Department of Minimally Invasive Surgery, Sacred Heart Medical Center
Current single incision laparoscopic surgery often requires the use of specialized ports or articulate laparoscopic instruments. The routine use of these instruments could increase the cost of such common operation. The goal of this prospective study is to evaluate the safety and the effectiveness of Single Incision Laparoscopic Cholecystectomy (SILC) using conventional non-articulate laparoscopic instruments.
Prospective study of all patients who under went SILC from July 2008 to August 2010 at Sacred Heart Medical Center, Oregon
There were 189 patients, 40 male and 149 female, with the mean age of 45 years old (range 14-90). The indications of cholecystectomy were acute cholecystitis in 29, gallbladder dyskinesia in 32, biliary colic in 47 and chronic cholecystitis in 81 patients. There were 154 outpatient surgeries. The mean operative time was 30.9 minutes (range 15-70). Seven patients had concurrent intra-cholangiogram. Two patients had concurrent single incision laparoscopic appendectomy. Keith needle was used in 72 patients (38%) only. Perioperative morbidity included one patient with cystic duct leak that was managed with non-operative approach. There were three hospital readmissions for right upper quadrant pain at the Keith needle entrance sites. After a mean follow-up of 5.8 months, no incisional hernia was reported. There was no perioperative mortality.
Single incision laparoscopic cholecystectomy can be performed safely using conventional non-articulate laparoscopic instruments without the need for specialized ports. The cost effectiveness of this technique may add to the armamentarium of general surgeons caring for patients with gallbladder disease.
Program Number: P472