What is the effective single incision laparoscopic biliary surgery platform: Needlescopic Grasper assisted single incision laparoscopc surgery

Abstract

Introduction: Single incision laparoscopic surgery has confirmed its safety and validity as a treatment option. We aimed to investigate the safety and feasibility of needlescopic grasper-assisted single-incision laparoscopic cholecystectomy(nSILC) and common bile duct exploration (nSIL-CBDE) by comparing the surgical outcomes of this technique with those of conventional laparoscopic CBDE (CL-CBDE). Method: We retrospectively analyzed the clinical data of patients who underwent CL-CBDE or nSIL-CBDE for the treatment of common bile duct (CBD) stones between January 2000 and December 2014. Also, We analyzed the medical records of the patients who underwent nSILC and CLC for benign gallbladder disease between January 2011 and December 2015. Results: Totally 1221 patients underwent laparoscopic cholecystectomy during the period. Among them, 577 patients underwent nSILC and 644 patients underwent CLC. The critical view of safety (CVS) obtaining success rate is more higher in nSILC group. However, there was no significant difference in operation time, and postoperative hospital stay (operation time: 57.9 ± 38.0 vs. 50.7 ± 30.8 minutes; P = 0.388, postoperative hospital stay: 2.5 ± 3.8 vs. 2.5 ± 1.6 minutes; P = 0.99). Totally 40 patients underwent laparoscopic CBDE during the period. Of these patients, 20 underwent CL-CBDE and 20 underwent nSIL-CBDE. The operative time for nSIL-CBDE was significantly longer than that for CL-CBDE. Postoperatively, the nSIL-CBDE group required less intravenous analgesic and had a shorter hospital stay than the CL-CBDE group. Conclusion: The results of this study suggest that nSILC and nSIL-CBDE could be safe and feasible in biliary tract disease.