Single Incision Laparoscopic Cholecystectomy vs Conventional Cholecystectomy in Developing Country

Dk Maharjan,Dr Singh,P B Thapa

doi:10.31729/jnma.91

Abstract

Use of laparoscopic surgery has demanded principles of less trauma of access hence less scar and so probably less complications. Hence conventional laparoscopic surgeries were tried with natural orifice transluminal surgery (NOTES) and then single incision laparoscopic surgery (SILS). With refinement in instruments and surgeons skills SILS have bridged up between conventional and NOTES in order to quench the desire of less or no scar at all. Comparative case control study between conventional laparoscopic cholecystectomy and SILS in public teaching hospital. Total 20 patients underwent SILS cholecystectomy and 20 underwent conventional cholecystectomy and found that no difference between both in terms of post operative pain score, hospital stay and post operative wound infection except significant difference in mean operative time and patient's level of satisfaction was less in patient with SILC if were subjected to pay for instruments in order to maintain cosmesis. Though SILS have gained rapid acceptance in surgical fraternity, large number of randomized controlled trials are necessary to show its benefit over conventional laparoscopic cholecystectomy.

Highlights

Use of laparoscopic surgery has demanded principles of less trauma of access less scar and so probably less complications
Mean operative time period was longer for single incision laparoscopic cholecystectomy (75 mins ± 5.7) than conventional laparoscopic cholecystectomy (39 mins ± 2.17) (P value -0.000)
When patients were asked about satisfaction level of surgery in terms of cosmesis, Table 1

Summary

Introduction

Use of laparoscopic surgery has demanded principles of less trauma of access less scar and so probably less complications. Conventional laparoscopic surgeries were tried with natural orifice transluminal surgery (NOTES) and single incision laparoscopic surgery (SILS). With refinement in instruments and surgeons skills SILS have bridged up between conventional and NOTES in order to quench the desire of less or no scar at all. In era of minimal invasive surgery, with wide spread use of laparoscopic surgery , the tendency of minimizing surgical trauma encourages the use of new approaches of less invasive along with scarless concept like natural orifice trans-luminal surgery (NOTES) and transumbilical single-incision laparoscopic surgery (SILS) are gaining wide acceptance.[1,2,3,4].

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Discussion

Conclusion