Lakshman Agarwal, Mbbs, MS. Swai man singh medical college, jaipur , rajasthan , india
Gall stones(cholelithiasis) are common condition . Advent of ultra sonography has increased its detection in a large way. The exact number of cholecystectomy performed in india is difficult to know as there is no standard national registery for it. We are practising SILS since last 4 years and the number exceed 600.
Langenbuch in 1882 did first open cholecystectomy, Conventional four port laparoscopic cholecystectomy(Philippe Mouret 1987) , Single incision laparoscopic cholecystectomy (Navarra 1997) and NOTES (Natural orifice transluminal endoscopic surgery )
MATERIAL AND METHODS: This study comprises of 600 cases of SILC (87% female and 13 % male )
A four fascial incision approach was used with conventional staright and reticulating instrument.
RESULTS: This study comprises of 600 cases of SILC (87% female and 13 % male) with AGE ranging from age 9-90( mean 39.91)
USG Findings in our study were Cholelithiasis with chronic cholecystitis (553 patients),Cholelithiasiswith acute cholecystitis (36 patients),Acalculouschlecystitis (7 patients) And Gall bladder polyp (4patients)
Previous Abdominal Surgery- Lap tubectomy 3%, hysterectomy 2%, L.S.C.S. 3%, Appendicectomy2%, Exploratory Laparotomy 2%.
Intra-Op Findings were – Adhesion 20%, distended gall bladder 12%, Contracted gall bladder 9%,normalgall bladder 59 %
Operative time range from 26.3 to 75 min ( mean 46.96 min )
Intra-Op Complications were – bleeding 5%, content leak from gallbladder 9% and spillage of stones in 5% patients
Conversion rate was 3%. Post-Operative Hospital stay was 1.24 + 0.46 days
Post-Operative Complications (wound infections) was 2%
Scar length was 2.07 cm (range 1.6-2.7 cm)
CONCLUSION: SILC is feasible, safe and reproducible with shorter hospital stay and better cosmesis , but has larger learning curve and longer operative time.
It does not add to cost if conventional instruments are used as we did in our study.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94859
Program Number: P199
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster