Noriaki Kameyama, PhD, Norihiro Kishida, MD, Satoshi Tabuchi, MD, Yuki Seo, PhD, Toshiki Yamashita, MD, Yoshinobu Akiyama, PhD. KKR Tachikawa Hospital
Background: We introduced the single port laparoscopic surgery in May 2009 and our experiences of single port surgery are 900 and more until April, 2016. The benign diseases occupied about 80% of them, such as cholecystectomy, appendectomy, and inguinal hernioplasty (TAPP and TEP). The majority, which occupied 45% of them is cholecystectomy.
At the first, the size of our transumbilical incision was 2.0cm and more. This size of incision is becoming shorter year after year. Now the size of our incision is only 1.0cm.
Methods: We make a 1.0cm incision at the bottom of umbilicus. After small laparotomy, we insert the Alexis wound retractor, size of XXS. 1.0cm of incision wound is the smallest size for the insert the sound retractor into the abdominal cavity. After the insert wound retractor, the surgical glove is attached and two low-profile laparoscopic 5mm ports are inserted through the holes of the surgical glove with cut fingertips. The original pre-bending forceps inserted directly through the hole of the cut fingertip. We usually use the 5mm flexible laparoscope by Olympus.
Results: We cannot detect the surgical wound on the patient in the one month after the operation.
Our average of hospital stay was 3.5 days, and operation time was 70 minutes for overall. (65 minutes for the expert.) The average of BMI in our patients is 24.6 Kg/m2.
The rate of complications is only 3.2%, and only one case is the incisional hernia. Our follow-up outcome is continued until one year after surgery.
A supplemental miniport or 5mm port including the conversion to conventional laparoscopic cholecystectomy, was required for 6.8%, and the conversion to open surgery is only one case.
Conclusions: We can perform the single port laparoscopic cholecystectomy via 1.0cm transumbilical incision. We believe that 1.0cm incision wound is the minimum for single port laparoscopic cholecystectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79264
Program Number: P117
Presentation Session: Poster (Video to Poster) (Non CME)
Presentation Type: Poster