scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

scholarly journals A comparative study of single incision laparoscopic cholecystectomy with conventional laparoscopic instruments versus multiple port laparoscopic cholecystectomy

2018 ◽  
Vol 5 (11) ◽  
pp. 3562
Author(s):  
Nagaraj S. Malladad ◽  
Ashwin Kulkarni
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Single Incision ◽  
Single Port ◽  
Postoperative Hospital Stay ◽  
Conversion Rates ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Time Required

Background: Treatment of gall stones have evolved markedly since open cholecystectomy was first described by Lange Buch in 1881. Management has progressed through eras of nonsurgical management, laparotomy, minilaparotomy and now laparoscopic cholecystectomy which is the gold standard for the treatment of gall stone disease today. Laparoscopic surgery is the procedure of choice for most benign gall bladder diseases unless obvious contraindication exists. There has been a trend toward minimizing the required number and size of ports to reduce postoperative pain with better cosmetic results.Methods: Comparative randomized study was conducted in Department of Surgery, SDM College of Medical Sciences and Hospital between February 2017 to July 2018. 60 patients who fit into the inclusion criteria were included in the study. 30 patients were included in the multiport cholecystectomy and 30 in the SILC. Random allocation of patients presenting with symptoms suggestive of gall bladder disease with confirmatory USG study. Group1: single incision laparoscopic cholecystectomy, Group2: multiple port laparoscopic cholecystectomy.Results: Majority of presenting patients were in age group 41-50 years. No significant difference in the mean age of patients, surgical complication, conversion rates and SSI operated by the two techniques. Median time required to complete cholecystectomy by SILC technique was not significantly higher than that required for multiport cholecystectomy. Statistically significant lower postoperative pain score was seen in patients with SILC compared to Multiport laparoscopic cholecystectomy. Patients operated by SILC technique had a postoperative hospital stay of mean 4.04 days, almost same as for patients operated by multiport technique.Conclusions: Difference of Conversion rates and time required for SILC is not significantly higher than that required for multiport cholecystectomy. No rise in intra and post-operative complications occurred in the single port surgery. Postoperative pain is significantly lower in patients undergoing SILC Length of postoperative hospital stay and incidence of SSI for single port cholecystectomy is almost as same as for multiport cholecystectomy.

scholarly journals Comparison of short-term outcomes between single incision laparoscopic cholecystectomy and conventional 4-port laparoscopic cholecystectomy

2019 ◽  
Vol 6 (3) ◽  
pp. 812
Author(s):  
Vishwanath . ◽  
Rajkumar Palaniappan ◽  
Balachandran Premkumar
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Cholecystectomy ◽  
Single Incision ◽  
Single Port ◽  
Case Series ◽  
Short Term ◽  
Significant Difference ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
The Mean

Background: Various numbers of case series, studies and randomized control trials conducted for comparison of Single port and Multi port cholecystectomy, however the benefit of Single Port cholecystectomy is still debatable.Methods: A prospective non-randomized comparative study was done to compare short term outcomes between SILS Cholecystectomy and Conventional 4-port Laparoscopic Cholecystectomy. Total of 85 patients underwent surgery out of which 5 cases were excluded (4 due to loss of follow up and 1 due conversion from SILS to LAP). There were 40 cases in each group, two group named as LAP (conventional 4-port laparoscopic cholecystectomy) group and SILS (single incision laparoscopic cholecystectomy) group.Results: On comparison of pain scores at 6 hours and 12 hours postoperatively and at the time of discharge between two groups there was significant difference at 12 hours postoperatively and at the time of discharge. The mean operative time in SILS group was similar to that of LAP group. The cosmesis score ranges from 2 to 10(1-5 for each questions) with 2 being best and 10 being worst appearance of scar. In LAP group, the mean cosmesis score was 4.65±0.9(SD) whereas, in SILS group it was 2.25±0.43(SD). On comparison between two groups there was significant difference (p= 0.0001). The quality of life total score on comparison between two groups there was significant difference in quality of life score (P=0.0001).Conclusions: It is concluded that SILS cholecystectomy is better than LAP and it should be preferred.

Morbidität und Letalität der Single-Incision-Cholezystektomie: eine 3-Jahres-Registeranalyse

2020 ◽  
Vol 145 (04) ◽  
pp. 390-398
Author(s):  
Maik Sahm ◽  
Anne-Katrin Reinsch ◽  
Ronny Otto ◽  
Christian Mönch ◽  
Martin Gerdes ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Cholecystectomy ◽  
Abdominal Surgery ◽  
Body Mass ◽  
Postoperative Komplikationen ◽  
Single Incision ◽  
Single Port ◽  
Single Incision Laparoscopic Cholecystectomy

Zusammenfassung Hintergrund Vor 2 Jahrzehnten wurde die Single-Incision-Chirurgie als neues Konzept in der minimalinvasiven Chirurgie etabliert. Die Cholezystektomie ist die am häufigsten durchgeführte Prozedur in dieser Technik. Die meisten Erkenntnisse beruhen auf randomisierten Studien. Es existieren keine groß angelegten multizentrischen Datenanalysen aus der klinischen Routine. Diese Analyse der klinischen Versorgungsforschung basiert auf der SILAP-Studie („single-incision multiport/single port laparoscopic abdominal surgery“). Patienten und Methode Die vorliegende Registerauswertung basiert auf Daten von 47 Kliniken im Zeitraum 2012 bis 2014. Die primären Endpunkte waren Gesamtmorbidität/Letalität. Multiple lineare und logistische Regressionsanalysen wurden durchgeführt. Die statistische Signifikanz war angegeben mit p < 0,05. Ergebnisse In der SILAP-Studie wurden die Daten von 975 Patienten mit Single Incision laparoscopic Cholecystectomy (SILC) in der klinischen Routine in einem Register erfasst. Die intraoperativen Komplikationen betrugen 3,2%. Die Rate der Gallengangverletzungen lag bei 0,1%. Postoperative Komplikationen traten in 3,7% der Fälle auf. Die Letalität war bei 0,2%. Die Operationszeit (Median) fiel im Studienverlauf von 60,0 auf 51,5 min (p = 0,001). Ein Zusatztrokar war in 10,3% der Fälle erforderlich. Die Konversionsrate zur konventionellen Cholezystektomie betrug 0,7%. In der multivariaten Analyse zeigten der Body-Mass-Index (p = 0,024), das männliche Geschlecht (p = 0,012) und die Operationszeit (p < 0,001) einen signifikanten Einfluss auf die intraoperativen Komplikationen. Patienten der ASA-Gruppe III (p = 0,001) und Patienten mit Zusatztrokaren oder der Konversion zur offenen Operation (p = 0,001) wurden als signifikante Faktoren bei den postoperativen Komplikationen ermittelt. Schlussfolgerung Die Registeranalyse dieser prospektiv multizentrisch erhobenen Daten zeigen, dass auch außerhalb der Selektionskriterien von randomisierten Studien die SILC in der klinischen Routine sicher durchführbar ist. Einzige Einschränkung ist ein BMI > 30 kg/m2, der einen signifikanten Einfluss auf die intraoperative Rate von Minorkomplikationen hatte.

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