Single incision laparoscopic cholecystectomy at UKM medical centre: an early experience

Abstract

Background: Laparoscopic cholecystectomy is the gold standard treatment for gallbladder disease. We have embarked on single incision laparoscopic cholecystectomy (SILC) at our institution. The aim of our study is to prove its safety, feasibility as well as patient’s satisfaction. Methods: 48 patients were recruited and underwent SILC at UKMMC between September 2014 to December 2016. All procedures were performed by a single experienced surgeon, under general anaesthesia. Results: 37 patients (77%) were female. The mean age was 50.2 years(range:18–80).The mean BMI was 22.9(range:19.0–28.1).7 patients need additional ports (1 port added in 3 patients, 2 ports added in 4 patients).This corelate with higher Cusheiri scale for difficulty.The conversion rates is 14.6%. The mean operating time was 82.3 minutes (range:40–170).The operating time varies widely partly due to technical difficulty and patient’s factor.This is also reflected by the long learning curve.The mean score for post operative pain was 3.3 (range:0–7) and none reported pain that interrupted daily activities.At 2 weeks follow-up, patients were highly satisfied with resultant scar. The mean satisfaction score was 8.9(range 7–10).4 patients (8.3%) developed grade 1 SSI at the umbilicus, which resolved with frequent dressing. Conclusion: SILC is technically challenging compared to conventional laparoscopic cholecystectomy. We conclude this technique is safe and feasible with high patients’ satisfaction for cosmesis and less post-operative pain.