Single-incision laparoscopic cholecystectomy using totally homemade glove port versus conventional laparoscopic approach: A cross-sectional study in a developing country

Abstract

PurposeSeveral home made glove ports for single-incision laparoscopic cholecystectomy (SILC) has been proposed but no comparison in surgical outcomes with conventional laparoscopic cholecystectomy (CLC) was made. Therefore, we aimed to compare the outcomes of SILC using a totally homemade glove port versus CLC. MethodsThis cross-sectional study compared the surgical outcomes between 90 patients, who underwent SILC and 123 patients who underwent CLC. Patients with acute cholecystitis grade 3 according to the Tokyo Guidelines 2018, body mass index ≥30, and previous abdominal surgeries were excluded. Totally homemade glove port was made of a small and a big rubber ring and a surgical glove to creat the wound retractor. Trocars were inserted into the glove's fingers. ResultsThe proportion of patients with acute cholecystitis was lower in the SILC group (7.78%) than in CLC (21.79%). Intraoperative complication rate, the prevalence of additional trocar or conversion to open surgery, success rate, and postoperative complication rate were similar between the two groups. However, SILC showed a significantly longer operative time (62.9 ± 25.1 verus 50.4 ± 20.7 min) and lower postoperative pain than CLC. The discrepancy in operative time was more likely to be remarkable in acute cholecystitis (50.43 min) compared with symptomatic cholelithiasis (14.28 min). ConclusionsThe SILC using a totally homemade glove port is feasible and safe compared with the CLC. However, in the case of acute cholecystitis, SILC should be indicated with caution because of the longer operative time than CLC.