Initial experience of single incision laparoscopic cholecystectomy (with video)

Li Ching Li, Huang Ming-Te, Chen Soul-Chin, Wei Po-Li, Wu Chih-Hsiung, Wang Weu

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: Single incision laparoscopic cholecystectomy (SILC) is a rapidly evolving field because of the reduced incisional morbidity, better cosmetic result, shorter hospital stay, and quicker return to activity. We report a technique and retrospectively reviewed our initial experience on SILC. To evaluate the feasibility and safety of the SILC using standard laparoscopic instruments and complying with the conventional surgical principle and technique of minimally invasive cholecystectomy. Materials and methods: From October 2008 to March 2009, 40 patients underwent SILC for the treatment of cholelithiasis at Taipei Medical University Hospital, Taipei, Taiwan. All these patients scheduled for an elective surgery underwent clinical evaluation and appropriate investigations. The exclusion criteria for SILC were acute cholecystitis, concomitant common bile duct stone, obstructive jaundice, previous upper abdominal surgery, and body mass index greater than 35kg/m2. The operation was completed laparoscopically through single 1.5cm subumbilical incision, through which 3 separate fascitomies were made in triangular form and introduced three 5mm trocars. A 5-mm 30-degree laparoscope was inserted through the trocar for visualization of the target area. A 5-mm clip was applied to ligate the cystic duct and artery through the others 2 ports alternatively after dissection. Finally, the gallbladder was taken out through the umbilicus and the fascial defect was closed with a direct suturing technique. Results: SILC was performed in 40 patients, 22 (55%) females and 18 (45%) males with a mean age of 46.9±10.9 years (range: 28 to 76y), the mean operative time was 54±21.2 minutes (range: 30 to 125min), and the mean hospital stay was 1.85±0.72 days (range: 1.0 to 2.5d); the mean dosage of the meperidine hydrochloride (Pethidine) was 0.23±0.4mg/kg, the mean pain intensity (Universal Pain Assessment Tool) is mild at 8 hours after surgery, and no pain at 24 hours, the conversion rate for additional incision was 5% (2 of 40).There was no perioperative and postoperative complication. There was no mortality in this study. Conclusions: The results of our initial experience in SILC showed that it is technically feasible and safe. No additional incisions were used and virtually no scar remained. The established procedure shows that initially learning curve by experienced and well-trained team can be easily overcome by reduced operative duration, postoperative complications, and conversion rate.

Original languageEnglish
Pages (from-to)243-246
Number of pages4
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume20
Issue number4
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Laparoscopic Cholecystectomy
Surgical Instruments
Meperidine
Length of Stay
Laparoscopes
Cystic Duct
Umbilicus
Pain
Acute Cholecystitis
Learning Curve
Cholelithiasis
Obstructive Jaundice
Common Bile Duct
Cholecystectomy
Pain Measurement
Operative Time
Gallbladder
Taiwan
Cosmetics
Cicatrix

Keywords

  • cholecystectomy
  • cholelithiasis
  • laparoscopy
  • single incision laparoscopic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Initial experience of single incision laparoscopic cholecystectomy (with video). / Li, Li Ching; Ming-Te, Huang; Soul-Chin, Chen; Po-Li, Wei; Chih-Hsiung, Wu; Weu, Wang.

In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, Vol. 20, No. 4, 08.2010, p. 243-246.

Research output: Contribution to journalArticle

@article{ebd66dfdc0ac41429da9092a8d2200fb,
title = "Initial experience of single incision laparoscopic cholecystectomy (with video)",
abstract = "Objective: Single incision laparoscopic cholecystectomy (SILC) is a rapidly evolving field because of the reduced incisional morbidity, better cosmetic result, shorter hospital stay, and quicker return to activity. We report a technique and retrospectively reviewed our initial experience on SILC. To evaluate the feasibility and safety of the SILC using standard laparoscopic instruments and complying with the conventional surgical principle and technique of minimally invasive cholecystectomy. Materials and methods: From October 2008 to March 2009, 40 patients underwent SILC for the treatment of cholelithiasis at Taipei Medical University Hospital, Taipei, Taiwan. All these patients scheduled for an elective surgery underwent clinical evaluation and appropriate investigations. The exclusion criteria for SILC were acute cholecystitis, concomitant common bile duct stone, obstructive jaundice, previous upper abdominal surgery, and body mass index greater than 35kg/m2. The operation was completed laparoscopically through single 1.5cm subumbilical incision, through which 3 separate fascitomies were made in triangular form and introduced three 5mm trocars. A 5-mm 30-degree laparoscope was inserted through the trocar for visualization of the target area. A 5-mm clip was applied to ligate the cystic duct and artery through the others 2 ports alternatively after dissection. Finally, the gallbladder was taken out through the umbilicus and the fascial defect was closed with a direct suturing technique. Results: SILC was performed in 40 patients, 22 (55{\%}) females and 18 (45{\%}) males with a mean age of 46.9±10.9 years (range: 28 to 76y), the mean operative time was 54±21.2 minutes (range: 30 to 125min), and the mean hospital stay was 1.85±0.72 days (range: 1.0 to 2.5d); the mean dosage of the meperidine hydrochloride (Pethidine) was 0.23±0.4mg/kg, the mean pain intensity (Universal Pain Assessment Tool) is mild at 8 hours after surgery, and no pain at 24 hours, the conversion rate for additional incision was 5{\%} (2 of 40).There was no perioperative and postoperative complication. There was no mortality in this study. Conclusions: The results of our initial experience in SILC showed that it is technically feasible and safe. No additional incisions were used and virtually no scar remained. The established procedure shows that initially learning curve by experienced and well-trained team can be easily overcome by reduced operative duration, postoperative complications, and conversion rate.",
keywords = "cholecystectomy, cholelithiasis, laparoscopy, single incision laparoscopic surgery",
author = "Li, {Li Ching} and Huang Ming-Te and Chen Soul-Chin and Wei Po-Li and Wu Chih-Hsiung and Wang Weu",
year = "2010",
month = "8",
doi = "10.1097/SLE.0b013e3181e9bbeb",
language = "English",
volume = "20",
pages = "243--246",
journal = "Surgical Laparoscopy and Endoscopy",
issn = "1530-4515",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Initial experience of single incision laparoscopic cholecystectomy (with video)

AU - Li, Li Ching

AU - Ming-Te, Huang

AU - Soul-Chin, Chen

AU - Po-Li, Wei

AU - Chih-Hsiung, Wu

AU - Weu, Wang

PY - 2010/8

Y1 - 2010/8

N2 - Objective: Single incision laparoscopic cholecystectomy (SILC) is a rapidly evolving field because of the reduced incisional morbidity, better cosmetic result, shorter hospital stay, and quicker return to activity. We report a technique and retrospectively reviewed our initial experience on SILC. To evaluate the feasibility and safety of the SILC using standard laparoscopic instruments and complying with the conventional surgical principle and technique of minimally invasive cholecystectomy. Materials and methods: From October 2008 to March 2009, 40 patients underwent SILC for the treatment of cholelithiasis at Taipei Medical University Hospital, Taipei, Taiwan. All these patients scheduled for an elective surgery underwent clinical evaluation and appropriate investigations. The exclusion criteria for SILC were acute cholecystitis, concomitant common bile duct stone, obstructive jaundice, previous upper abdominal surgery, and body mass index greater than 35kg/m2. The operation was completed laparoscopically through single 1.5cm subumbilical incision, through which 3 separate fascitomies were made in triangular form and introduced three 5mm trocars. A 5-mm 30-degree laparoscope was inserted through the trocar for visualization of the target area. A 5-mm clip was applied to ligate the cystic duct and artery through the others 2 ports alternatively after dissection. Finally, the gallbladder was taken out through the umbilicus and the fascial defect was closed with a direct suturing technique. Results: SILC was performed in 40 patients, 22 (55%) females and 18 (45%) males with a mean age of 46.9±10.9 years (range: 28 to 76y), the mean operative time was 54±21.2 minutes (range: 30 to 125min), and the mean hospital stay was 1.85±0.72 days (range: 1.0 to 2.5d); the mean dosage of the meperidine hydrochloride (Pethidine) was 0.23±0.4mg/kg, the mean pain intensity (Universal Pain Assessment Tool) is mild at 8 hours after surgery, and no pain at 24 hours, the conversion rate for additional incision was 5% (2 of 40).There was no perioperative and postoperative complication. There was no mortality in this study. Conclusions: The results of our initial experience in SILC showed that it is technically feasible and safe. No additional incisions were used and virtually no scar remained. The established procedure shows that initially learning curve by experienced and well-trained team can be easily overcome by reduced operative duration, postoperative complications, and conversion rate.

AB - Objective: Single incision laparoscopic cholecystectomy (SILC) is a rapidly evolving field because of the reduced incisional morbidity, better cosmetic result, shorter hospital stay, and quicker return to activity. We report a technique and retrospectively reviewed our initial experience on SILC. To evaluate the feasibility and safety of the SILC using standard laparoscopic instruments and complying with the conventional surgical principle and technique of minimally invasive cholecystectomy. Materials and methods: From October 2008 to March 2009, 40 patients underwent SILC for the treatment of cholelithiasis at Taipei Medical University Hospital, Taipei, Taiwan. All these patients scheduled for an elective surgery underwent clinical evaluation and appropriate investigations. The exclusion criteria for SILC were acute cholecystitis, concomitant common bile duct stone, obstructive jaundice, previous upper abdominal surgery, and body mass index greater than 35kg/m2. The operation was completed laparoscopically through single 1.5cm subumbilical incision, through which 3 separate fascitomies were made in triangular form and introduced three 5mm trocars. A 5-mm 30-degree laparoscope was inserted through the trocar for visualization of the target area. A 5-mm clip was applied to ligate the cystic duct and artery through the others 2 ports alternatively after dissection. Finally, the gallbladder was taken out through the umbilicus and the fascial defect was closed with a direct suturing technique. Results: SILC was performed in 40 patients, 22 (55%) females and 18 (45%) males with a mean age of 46.9±10.9 years (range: 28 to 76y), the mean operative time was 54±21.2 minutes (range: 30 to 125min), and the mean hospital stay was 1.85±0.72 days (range: 1.0 to 2.5d); the mean dosage of the meperidine hydrochloride (Pethidine) was 0.23±0.4mg/kg, the mean pain intensity (Universal Pain Assessment Tool) is mild at 8 hours after surgery, and no pain at 24 hours, the conversion rate for additional incision was 5% (2 of 40).There was no perioperative and postoperative complication. There was no mortality in this study. Conclusions: The results of our initial experience in SILC showed that it is technically feasible and safe. No additional incisions were used and virtually no scar remained. The established procedure shows that initially learning curve by experienced and well-trained team can be easily overcome by reduced operative duration, postoperative complications, and conversion rate.

KW - cholecystectomy

KW - cholelithiasis

KW - laparoscopy

KW - single incision laparoscopic surgery

UR - http://www.scopus.com/inward/record.url?scp=77956260487&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956260487&partnerID=8YFLogxK

U2 - 10.1097/SLE.0b013e3181e9bbeb

DO - 10.1097/SLE.0b013e3181e9bbeb

M3 - Article

C2 - 20729693

AN - SCOPUS:77956260487

VL - 20

SP - 243

EP - 246

JO - Surgical Laparoscopy and Endoscopy

JF - Surgical Laparoscopy and Endoscopy

SN - 1530-4515

IS - 4

ER -