Page 10 - Jourmal of World Association of Laparoscopic Surgeon

Kadhim Abdullah et al

facial defect and 3/0 Vicryl stitches was used to close the on the same day except two patients. One patient was
umbilical skin. discharged on the second day. The other one stayed for 48
hours for social issue. The average blood loss during
RESULTS procedures was minimal and there was no need for blood

Most of patients were female (F/M = 20/2) with average transfusion.
age 37.27 (24 to 70) years. All patients have symptomatic No vascular or bowel injuries were seen on entering the
cholelithiasis with no emergency cases included. The mean peritoneal cavity. No intraoperative complications were
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BMI was 25.25 kg/m . General health state of all patients found. No extension of primary incision was performed.
were assessed using American Society of Anesthologist Surgical principle of exposure and dissections were
(ASA) scoring system 1 and 2. followed. Critical view of safety was demonstrated in all
The mean operative time for 19 patients was 69.21 cases. There was no need for routine intraoperative
minutes (30-90). No records of operative time were found cholangiogram as this is not the trust policy. Postoperative
in three cases due to missing data. All cases underwent pain was assessed using visual analog scale and the mean
laparoscopic cholecystectomy using single port through was less than one. Patients were given simple oral analgesia
umbilicus except one patient who had an extra-port for which succeeded to control their mild-to-moderate
inadequate exposure. All patients had cholelithiasis. Straight postoperative pain. Most patients said that there was no need
conventional laparoscopic instruments including 5 mm to take regular analgesia after being discharged from
30º laparoscopes were used.
There was no conversion to conventional laparoscopic Table 1: Operative outcomes of SPLC
or open cholecystectomy. Some of the missing data was Operative time (min) 69.21 (30-90)
extracted either from electronic record of the patients or Complication All minors: Total 5 (22.7%)
from the operating surgeon notebook. • • 3 gallbladder perforations (13.6%)
1 bleeding: No transfusion needed
There were five minor complications in this series • 1 readmission for pain control
(Table 1). We had three gallbladder perforations by Critical view of safety Demonstrated in all cases
Conversion None
electrocautery. One case had bleeding intraoperatively One extra-port added due to
which was controlled easily by diathermy. One patient was inadequate exposure
readmitted for abdominal pain which got controlled Hospital stays (hours) <24 hours (the mean 10.05 hours)
Pain score (VAS)
<1
conservatively. Operative time appear to decline signi- Blood loss Minimum
ficantly after the first 18 cases and was around 30 minutes Patient satisfaction Satisfied 100% (14 patients surveyed)
in the last four procedures (Table 2). All patients discharged Success rate 95.45%

Table 2: Summary of perioperative outcomes of SPLC
Patients Operative time Cri v safety Complication Pain Hosp stay Conversion
1 90 Yes No 0 Same day No
2 85 Yes No 0 Same day No
3 90 Yes No 0 Same day No
4 50 Yes No 0 Same day No
5 90 Yes No 0 Same day No
6 65 Yes No 0 24 hours No
7 80 yes Bleeding 2 readmission No
8 50 Yes No 0 Same day No
9 75 Yes No 0 Same day No
10 60 Yes No 0 Same day No
11 90 Yes No 2 Same day No
12 90 Yes GB perforation 0 48 hours No
13 70 Yes No 0 Same day No
14 Missing Yes No NR NR One extra-port
15 90 Yes GB perforation 0 Same day No
16 Missing Yes No NR NR No
17 Missing Yes No NR NR No
18 80 Yes GB perforation 0 Same day No
19 45 Yes No 0 Same day No
20 35 Yes No 0 Same day No
21 30 Yes Pain 2 Same day No
22 50 Yes No 0 Same day No
Cri v safety: Critical view of safety; GB: Gallbladder; NR: Not recorded
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