Single Incision Laparoscopic Cholecystectomy

Nihat Yavuz, MD¹, Serkan Teksoz, MD², Engin Hatipoglu, MD², Sabri Erguney, MD², Tuna Yildirim, MD¹, Sirri Ozkan, MD¹. ¹Acibadem Kadikoy Hospital,General Surgery Department, ²Istanbul University,Cerrahpasa Medical School,General Surgery Department

Introduction: Thanks  to technological advances, laparoscopic surgery continues to evolve . One recent advance in this field is laparoscopy performed through a single incision. In this study we present our experiences concerning cholecystectomy through a single incision.   

Materials and Methods: Between November 2009 and September 2015 we performed single incision laparoscopic cholecystectomy in 505 patients.335 of the patients were female, 170 were male.The mean age was 44 years (range:7-79 years). 44 patients presented with acute cholecystitis,others with cholelithiasis. In 12 cases an ERCP had been performed preoperatively. The procedures were realized using a SILS portTM  (COVIDIEN®) , flexible and articulated instruments (COVIDIEN®) and 5 mm endoclip as the ligation device (COVIDIEN®)  and  electrocautery as the energy source

Results: Average operative time was 33 minutes (20-240 minutes).An additional trocar was inserted in 13 cases,because of difficulty at exploration in 10 , for bleeding control in two and because of a choledocal cyst in one other case. An abdominal drain was used in 24 cases,which had been removed the following day.No conversation to laparoscopic or conventional surgery. Postoperative complications occurred in 13 cases:Bile leakage due to accessory bile duct in one case,wound problems(seroma and infection) in 10 cases and hernia in two cases. Nonsteroid antiinflammatory agents had been used for postoperative analgesia. Mean hospital stay was 1.02 day (range:1-3 days).

Conclusion: With its superiority of scarlessness, single port laparoscopic cholecystectomy may be admitted as an alternative method to its multiport counterpart