Single-incision laparoscopic cholecystectomy: a novice technique

Abstract

Background: Laparoscopic Cholecystectomy has been recognized since 1992 as the gold standard procedure for gallbladder surgery. Single-incision laparoscopic cholecystectomy (SILC) is a relatively new technique that has attracted the attention of all the laparoscopic surgeons worldwide. Methods: The author shares his small experience of single-incision laparoscopic cholecystectomy in 80 cases as a step toward less invasive surgical procedures. The procedure was done with the conventional instruments used for laparoscopic cholecystectomy. A single intraumbilical 15-20 mm incision was given. Two ports, one 10mm and the other 5mm are introduced through the incision with a fascial bridge between them (one for 5 mm 30 laparoscope and other for 10mm right angled dissector). Two sutures placed through abdominal wall retracted the gall bladder. After Calot’s triangle dissection, cystic duct and artery were clipped and divided. Cholecystectomy was completed with electrocautery and the gall bladder was retrieved through umbilical incision. Results: The author performed SILC in 80 patients between January 2010 and December 2012 and completed it successfully. The procedures were performed for elective indications only. One additional 5-mm port had to be placed in two patients. One patient with acute cholecystitis required conversion to four-port cholecystectomy. Almost 50% patients who had elective SILC could be discharged the day after surgery. There were no postoperative or wound-related complications and all the patients were very pleased with the cosmetic outcome. Conclusions: As per the available literature, the SILC technique is safe, feasible and reproducible. The learning curve can be steepened with experience and better results can be obtained.