Objective: To describe a single surgeon’s experience with single incision laparoscopic surgery ( SILS) including cholecystectomy, appendectomy, right(Rt) colectomy and lysis of adhesions (LOA). The primary goal of SILS is to minimize or eliminate visible scarring by using a single umbilical incision. The purpose of this study was to demonstrate that SILS outcome is comparable with conventional laparoscopic surgery in terms of complications, length of stay (LOS), post op narcotic use and return to normal activity.
Methods: A retrospective chart review was performed on a total of 67 SILS cases: 59 cholecystectomies with cholangiograms, 5 appendectomies, 2 Rt colectomies, and one LOA (51 males, 16 females; ages 18-84 years) from November 2008 to September 2009. Outcome measures included age in years, body mass index (BMI) in Kg/m2, operative time (OT) in minutes, need for conversion, LOS in days, post op analgesia, days to normal activity, post operative complications and cosmetic outcome. Xx patients were called 6 months postop to document new hernias and other complications.
|Procedure||Mean age||Mean BMI||Mean OT||Mean LOS||Conversions (additional 2mm and 5mm ports)||Mean Post-op Narcotic Use||Mean days to normal activity||Complications|
|Cholecystectomy||49||28.5||95||1 day||25||2 days||3.2||none|
|Appendectomy||47||23.8||55||d/c same day||1||2.8||3||none|
|LOA||39||34||45||d/c same day||1||4||6||none|
|Rt Colectomy||63.5||33.5||142.5||6.5 days||1||5||10||Wound infection in one case|
None of the above cases required conversion to open surgery and all the patients were very satisfied with the better cosmetic outcome. None of the patients contacted at 6 months reported umbilical pain or bulge.
Conclusion: In this series of operations, SILS was shown to be a safe and feasible method for appendectomy and cholecystectomy, with results comparable to conventional laparoscopic surgery but with improved cosmesis. However further studies and larger series are required to demonstrate the efficacy of SILS in performing LOA and Rt colectomy. Followup beyond 6 months is indicated to assess the true incidence of post operative umbilical hernias.
Program Number: P531