Efficacy and Safety of Single Port Laparoscopic Cholecystectomy: A Single Institute Experience

Abstract

Background: Over the past 5 years, minimal access surgery has been moved toward a new less invasive single port access surgery. Like any new technique, there is a need to ensure that basic tenets of safety and efficacy are maintained. In this study, we demonstrate the efficacy and safety of single port laparoscopic surgery for cholecystectomy in 22 consecutive cases in single institution. Materials and methods: It is a case series of 22 patients (20 females/2 males) who underwent single port laparoscopic cholecystectomy (SPLC) a single laparoscopic surgeon at Barts and the Royal London NHS Trust performed all surgeries using straight conventional instruments from July 2009 to May 2011. Results: In our series, the operations were performed by SPLC successful in 21 patients. In one case an extra-port was added due to inadequate exposure. The mean age was 37.27 years (24-70). The mean BMI was 25.25 kg/m2 (21.1-35). The mean operative time was 69.21 minutes (30-90). Gallbladder perforations were recorded in three cases. Minor bleeding was found in one case. The mean hospital stay was <24 (10.05) hours. Visual analog scale was used to record pain severity and the mean was less than one. All patients had uneventful recovery. Conclusion: The results from current series show SPLC to be a promising technique. We established in this series that SPLC is a safe, efficacious and feasible technique, but it took longer to perform than standard surgery. It can be performed using straight instruments. However, routine application of this novel technique requires evaluation of its safety and effectiveness in large randomized studies. Abbreviation: SILS: Single incision laparoscopic surgery; SIMPLS: Single incision multiport laparoscopic surgery; OPUS: One port umbilical surgery; TUES: Transumbilical endoscopic surgery; SPAS: Single port access surgery, are acronyms of LESS: Laparoendoscopic single site surgery.