Single-Incision Laparoscopic Cholecystectomy: Safe, Fast, and Easy to Learn

Justin Tawfik, Brandon Foles, Rhonda Harmon, Jean Miner

Florida Hospital

INTRODUCTION
Many studies demonstrate that single-incision laparoscopic cholecystectomy (SILC) is a safe alternative to conventional 4-port laparoscopic cholecystectomy (CLC). Most studies show an increased operative time with SILC. However, no study evaluates SILC from a resident’s perspective. We look to contribute to this growing body of research as well as add our resident’s experience with this operative technique.

METHODS
This is a retrospective study comparing operative times, complications, and blood loss between single-incision laparoscopic cholecystectomy and conventional 4-port laparoscopic cholecystectomy for both attending and resident surgeons. 334 patients underwent cholecystectomy during 2007 to 2010 at a single institution. 221 patients underwent CLC and 113 patients underwent SILC. Laparoscopic cholecystectomies were performed by six surgeons and by six residents, ranging from PGY2 to PGY4.

RESULTS
Operative times were increased with SILC (SILC 73 minutes vs. CLC 67 minutes) but similar when residents performed the operation (SILC 80 minutes vs. CLC 79 minutes). Mean operative times when performing a cholecystectomy in conjunction with intraoperative cholangiogram was similar as well (SILC 81 minutes vs. CLC 88 minutes). Operative blood loss was similar between techniques. There was one intraoperative complication during with SILC (minor vessel injury with trocar placement, 9% intraoperative complication rate); there were two complications with CLC (common bile duct transaction and bowel injury with trocar placement, 9% intraoperative complication rate).

CONCLUSION
Single-incision laparoscopic cholecystectomy is an acceptable alternative to conventional 4-port laparoscopic cholecystectomy. SILC can be performed with efficacy, safety, and reasonable operative times. SILC is also safe in the hands of the surgeon in training, the resident.

Session: Poster Presentation

Program Number: P560