55 Laparoscopic Cholecystectomies Using Single Incision Laparoscopic Surgery– Initial Experience

Overview

Introduction:
Laparoscopic cholecystectomy is currently the commonest laparoscopic procedure, and is considered the method of choice in the treatment of cholecystolithiasis. Advancements in miniinvasive surgery allowed for gradual reduction in the number of ports and resulted in introduction of single incision laparoscopic surgery. Single Incision Laparoscopic Surgery (SILS) – is a laparoscopic method, in which all working ports are introduced into a single, umbilical, incision. LESS (Laparo Endoscopic Single – Site Surgery) – a miniinvasive procedure using a specialized multi-instrumental port (Tri-port^©), introduced in the periumbilical region. The authors present the following two methods of single incision laparoscopic cholecystectomy: using three individual ports or using a port, specialized for the method.

Material and Methods:
Retrospective assessment of all patients, who were operated using single incision laparoscopy at the Surgical Clinic of 2nd Faculty Medicine of the Charles University and at the Central Military Hospital Prague (ÚVN Praha), from December 2008 to October 2009. The authors assessed age, gender, body-mass index, procedure duration, blood loss during operations, indications for the procedures and postoperative complications. The data collected were analyzed with descriptive statistics methods, using the Excel tabulator.

Results:
During the 11-month period, a total of 50 patients underwent SILS cholecystecomy. The procedure was indicated for cholecystolithiasis (66%), cholecystitis (28%) and gallbladder polyps (6%). No serious complications were recorded, a single patient (2%) suffered from wound infection. LESS cholecystectomy for symptomatic cholecystolithiasis was performed in 5 patients. No complications were recorded.

Conclusion:
Single Incision Laparoscopic Cholecystectomy is a promising method, combining general advantages of laparoscopic surgery and minimizing abdominal wall injury, since the incision site is located within the existing umbilical scar. Due to technical advancements, it is a safe method, comparable to conventional laparoscopic procedures.

Key words:
laparoscopy – SILS – LESS