Single Incision Laparoscopic Cholecystectomy-A Single Centre Experience Using Conventional Instruments

Manash Sahoo, MS, Anil Kumar, Post, Graduate

S C B Medical College

AIM: To assess the feasibility of single-incision laparoscopic surgery using conventional laparoscopic instruments.

METHODS AND DESCRIPTION OF TECHNOLOGY: From January 2007 to March 2012, 120 patients with symptomatic gallstone disease underwent Single Incision Laparoscopic surgery (SILS) through a 2.5cm supraumbilical incision using a three-port technique (one 11mm and two 6mm standard laparoscopic cannula). For all these patients, a 30 degree angled scope and standard laparoscopic instruments were used, with no usage of single port devices and roticulating instruments. The gallbladder was retracted, with one suture placed over the fundus of gallbladder. These sutures were taken on the fundus and puppet technique was used to obtain a critical view of Calot’s triangle. The cystic duct and artery were well visualized, clipped, and divided. Cholecystectomy was completed, and the specimen was retrieved through the umbilical incision (11mm port).

RESULTS: In this series 81 females and 39 males (n =120), average age 42.5 years (19-77 years) chosen by predefined criteria underwent SILS using conventional straight instruments. The mean operative time was 86.5 min (65-120 min). A three trocar single incision technique was feasible for 95% (n=115) of the patients. For the remaining patients, conversion to standard 4 port approach was done. No conversion to open surgery was required. Patients have been followed up for a mean of 13 months (5-30 months) and till now no notable complications have been reported.

CONCLUSION: Single-incision laparoscopic cholecystectomy is safe, feasible, and quite reproducible in experienced hands with use of only conventional laparoscopic instruments without use of single port devices and roticulating instruments.


Session: Poster Presentation

Program Number: ETP009

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