Page 11 - Journal of Laparoscopic Surgery - WALS Journal

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10.5005/jp-journals-10033-1261
Comparative Study of Single-incision Laparoscopic Cholecystectomy with Four-port Conventional Laparoscopic Cholecystectomy
ORIGINAL ARTICLE

Comparative Study of Single-incision

Laparoscopic Cholecystectomy with Four-port
Conventional Laparoscopic Cholecystectomy:

A Single-center Experience

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1 Apoorv Goel, Priyanka Chaubey, Atul Gupta, Shalabh Gupta, Ayush Agarwal, Deepak Bhardwaj
ABSTRACT INTRODUCTION
Aims and objective: To assess the feasibility of single- Laparoscopic cholecystectomy (LC) is the gold standard
incision laparoscopic cholecystectomy (SILC) with conventional treatment for cholelithiasis all over the world. This
laparoscopic instruments and to compare it with four-port
conventional laparoscopic cholecystectomy (LC) regarding operation is conventionally performed using four
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various intraoperative and postoperative factors. ports into the abdomen. The tendency of minimizing
surgical trauma encourages the use of new approaches
Materials and methods: This is a prospective randomized 2
controlled study carried out at Santosh Medical College in laparoscopic surgery. In recent years, successful
and Hospitals, Ghaziabad from March 2014 to September attempts to reduce the number of traditionally used four
2015. This study included 60 patients with cholelithiasis ports have been reported. Reducing the number of ports
3,4
who were divided into two groups of 30 patients each. Group I has been shown to improve cosmetic outcomes. Later,
was offered four-port conventional LC and group II underwent three-port and two-port LC were described, which have
SILC.
been reported as safe and feasible. 3,4
Results and observations: Cholelithiasis was commonly In the new era of minimal access surgery, the pre-
seen in young females. Single-incision laparoscopic cholecys- ferred outcomes under consideration are not only the
tectomy took more operating time than conventional LC due safety, but also the quality, which is often defined by pain
to more operative difficulty. Outcome of SILC was 79.6% (23
of 30). However, postoperative complications and pain (meas- and cosmetic results. Scarless surgery is the ultimate goal
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ured by visual analog scale scoring system) were almost the of laparoscopic surgery. Single-incision laparoscopic
same in both groups. Cosmetic outcome was better in SILC cholecystectomy (SILC) can be performed using refine-
group. ments of existing technology, and surgeons can perform
Conclusion: Single-incision laparoscopic cholecystectomy SILC without any new instruments, specific competence,
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has no added advantage over conventional LC, but it can be or training. Natural orifice transluminal endoscopic
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performed in selected patients for better cosmetic results. surgery (NOTES) is now being performed at many
centers across the globe, which eliminates all possibility
Keywords: Cholelithiasis, Intraoperative factors, Laparoscopic
cholecystectomy, Postoperative factors, Single-incision lapa- of scar formation.
roscopic cholecystectomy. Single-incision laparoscopic cholecystectomy was
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described as early as 1992 by Pelosi et al, who performed
How to cite this article: Goel A, Chaubey P, Gupta A, Gupta S,
Agarwal A, Bhardwaj D. Comparative Study of Single-incision a single-puncture laparoscopic appendectomy, and
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Laparoscopic Cholecystectomy with Four-port Conventional in 1997, by Navarra et al, who performed an LC via
Laparoscopic Cholecystectomy: A Single-center Experience. two transumbilical trocars and three transabdominal
World J Lap Surg 2016;9(1):9-12. gallbladder stay sutures. The objective of this study was to
Source of support: Nil compare conventional four-port LC with SILC regarding
various intraoperative and postoperative factors.
Conflict of interest: None
AIMS AND OBJECTIVE

1,5 Assistant Professor, 2,6 Postgraduate Trainee, Professor To assess the feasibility of SILC with conventional
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4 Professor and Head laparoscopic instruments and to compare it with four-
1-6 Department of General Surgery, Santosh Medical College port conventional LC regarding various intraoperative
and Hospitals, Ghaziabad, Uttar Pradesh, India and postoperative factors.
Corresponding Author: Apoorv Goel, Assistant Professor
Department of General Surgery, Santosh Medical College MATERIALS AND METHODS
and Hospitals, Ghaziabad, Uttar Pradesh, India, Phone: This prospective randomized controlled study was
+911204107140, e-mail: drapurvgoel@gmail.com
conducted in the Department of General Surgery at
World Journal of Laparoscopic Surgery, January-April 2016;9(1):9-12 9