Nobumi Tagaya, PhD, Yoshitake Sugamata, PhD. Department of Surgery, Dokkyo Medical University Koshigaya Hospital
Introduction: Obesity has been influenced the outcomes of laparoscopic surgery. Here we investigate the influence of obesity during single-incision laparoscopic cholecystectomy (SILC).
Patients and methods: We performed SILC in 298 patients, comprising 146 males and 152 females with a mean age of 55 years. Their diagnoses included 276 gallbladder stones, 15 polyps and 7 adenomyomatosis. Body mass index (BMI) were divided into 4 groups consisting of less than 25 kg/m2 (A), 25-30 kg/m2 (B), 30-35 kg/m2 (C) and more than 35 kg/m2 (D). We made a 2.5-cm longitudinal skin incision within the umbilicus. A wound retractor and a surgical glove were applied at that incision. We used the three 5-mm ports technique. After retracting the gallbladder upward, the cystic duct and artery were divided and identified using pre-bending forceps through the flexible port and laparoscopic coagulating shears (LCS). The cystic artery was dissected using the LCS and the cystic duct was also dissected after clipping. The gallbladder was freed from the liver bed using the LCS, and the specimen was retrieved from the umbilical wound.
Results: There were conversions to open laparotomy in 4 cases (1.3%) and requirement of additional ports in 23 (7.7%). The mean age (years), operation time (min), blood loss (ml) and postoperative hospital stay (days) in group A, B, C and D were 60.0, 55.5, 51.2 and 41.2 (p=0.05>), 89.5, 101.7, 98.4 and 85.3 (p=0.206), 19.7, 18.5, 15.6 and 3.4 (p=0.935), and 3.5, 3.6, 3.2, and 3.0 (p=0.882), respectively. There was a significant difference in age only. The complications were bile duct injury in one case (0.3%) and pneumothorax in two (0.6%).
Conclusion: Obesity had no influence of surgical outcomes for performing SILC.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88159
Program Number: P117
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster