Abstract
Background
An increasing number of techniques are emerging in the literature describing single-incision laparoscopic cholecystectomy (SILC). The advent of a new surgical approach is a reminder of the increase in bile duct injuries in the past when laparoscopic cholecystectomy was first introduced. With this in mind, the authors describe a safe and reproducible approach to SILC.
Methods
Between August 2008 and August 2009, 20 patients with symptomatic gallbladder disease underwent SILC using a totally transumbilical fundus-first approach with an intraoperative cholangiogram. Data including pain scores were collected prospectively.
Results
In this initial series, the median operative time was 103 min (range, 55–177 min), including the time for two patients undergoing additional procedures at the time of surgery. Intraoperative cholangiograms were completed for 18 of 19 patients. Additional ports were required in four patients for safe completion of the procedure. The mean pain score 12 h postoperatively was 2.5 on a visual analogue scale with a range of 0–10. There was no morbidity or mortality.
Conclusion
According to the findings, SILC with an intraoperative cholangiogram can be performed safely using a fundus-first approach. However, for SILC to become the operation of choice for the treatment of gallbladder disease, evidence is required to demonstrate its advantage over laparoscopic cholecystectomy.
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Disclosures
A. G. Patel, B. Murgatroyd, K. Carswell, and A. Belgaumkar have no conflicts of interest or financial ties to disclose.
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Patel, A.G., Murgatroyd, B., Carswell, K. et al. Fundus-first transumbilical single-incision laparoscopic cholecystectomy with a cholangiogram: a feasibility study. Surg Endosc 25, 954–957 (2011). https://doi.org/10.1007/s00464-010-1240-6
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DOI: https://doi.org/10.1007/s00464-010-1240-6