Single incision laparoscopic cholecystectomy: A single center experience

Introduction: Single Incision Laparoscopic Surgery (SILS) is a variation in which trocar scars are hidden in the umbilicus. We sought to determine whether SILS cholecystectomy is a safe alternative to a conventional laparoscopic cholecystectomy. Methods: We retrospectively reviewed our series of 205 SIL cholecystectomies (SILC) performed between May 2008-June 2010. The first 50 cases were done by initially insufflating the abdomen with a veress needle through the umbilicus and then placing 3, 5 mm ports in the umbilicus. The remaining cases were performed using a cut down approach at the umbilicus, followed by placement of a three-trocar SILS port under direct vision. Results: Two hundred and five patients (M:F = 48:157) underwent SILC during the study period. Median age was 45 (range = 21-62). Mean BMI range was 35 (range = 21-44). Mean operative time was 60 min (range = 40-120 min) and a follow up period that ranges from 1 to 21 months. Patient pathologies included: Chronic cholecystitis (74%), Acute cholecystitis (17%), Choledocholithiasis (6.8%), Gallstone pancreatitis (2%) and gallbladder polyp (0.5%). An additional port was placed in the umbilicus in 3% of cases. No cases were converted to open. Complications occurred in 4% of cases including: 3 patients with retained stones, 2 patients with post-op wound infection, 2 patients with incisional hernias in the umbilical region and 1patient with a veress injury. Conclusion: SIL cholecystectomy can be done safely. It offers a better cosmetic result, which may lead to greater patient satisfaction.