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RESEARCH ARTICLE
Laparoscopic Cholecystectomy: Single-port vs Traditional

Procedure: Our Experience

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Selmy Mohamed Awad , Ibrahim Dawoud , Waleed Althobiti , Shaker Alfaran , Saleh Alghamdi , Saleh Alharthi , Khaled
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Alsubaie , Soliman Ghedan , Rayan Alharthi , Majed Asiri , Azzah Alzahrani , Nawal Alotaibi , Mohamed Shetiwy 13
AbstrAct
Background: Laparoscopic surgery is widely accepted as a reliable alternative to the open approach across surgical disciplines. Benefits of
single-incision laparoscopic surgery (SILS), as exemplified here by single-port laparoscopic cholecystectomy (SPLC), have yet to be formally
proved. However, the hypothesized benefits of SILS would include those of standard traditional laparoscopic surgery plus improved esthetic
outcomes, with surgery being performed through a single hidden incision.
Methods: All patients who had chronic calcular cholecystitis at the General Surgery Department at Mansoura University Hospital between
May 2014 and May 2018 were eligible for this study to compare SPLC with multiport laparoscopic cholecystectomy (MPLC). Operative and
perioperative outcomes, including cosmesis, were analyzed.
Results: SPLC had been performed in Group A (40 patients), mean age was 37.35 ± 10.72, 80% were females, and mean BMI was 30.15 ± 4.53.
MPLC was performed in Group B (40 patients), mean age was 40.70 ± 9.71, 75% were females, and mean BMI was 28.35 ± 2.83. The average
duration of postoperative hospital stay in SPLC cases was 24 hours and in MPLC group was 25.20 hours, with p = 0.330, which was insignificant.
In the SPLC group, the mean operative time was 95.75 minutes whereas in the MPLC group the mean operative time was 42.10 minutes.
Therefore, the mean operative time in the SPLC group was significantly higher than in the MPLC group (p <0.01). Esthetic results were better
in the SPLC group than in the MPLC group.
Conclusion: Based on the current findings, SPLC seems to be a safe procedure in uncomplicated cholecystitis with rapid recovery, less
postoperative pain, less wound infection, and better cosmesis. The operative time was long. However, patients should be aware of the risks of
port-site incisional hernia and instructed to avoid heavy work and exercises during the first three postoperative months.
Keywords: Laparoscopic cholecystectomy, Single-port, Traditional.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1482
IntroductIon 1,2,13 Department of General Surgery, Mansoura University Hospitals,
Laparoscopic surgeries are special techniques by which surgeons Mansoura, Egypt
perform the operations via several tiny holes in the abdomen with 3–12 Department of General Surgery, King Faisal Medical Complex, Taif,
the help of a camera. It is known also as minimally invasive surgery Saudi Arabia
(MIS). These incisions are much smaller than traditional surgical Corresponding Author: Selmy Mohamed Awad, Department of
techniques. 1 General Surgery, Mansoura University Hospitals, Mansoura, Egypt,
Diminished postoperative pain, fast recovery, improved esthetic Phone: 0556466097, e-mail: selmysabry2007@yahoo.com
outcomes, and short hospital stay are the documented benefits How to cite this article: Awad SM, Dawoud I, Althobiti W, et al.
across a spectrum of surgical procedures. Many procedures have Laparoscopic Cholecystectomy: Single-port vs Traditional Procedure:
been done safely with laparoscopy. These include laparoscopic Our Experience. World J Lap Surg 2021;14(3):221–226.
cholecystectomy that has supplanted open cholecystectomy for Source of support: Nil
most gallbladder pathologies. 2,3 Conflict of interest: None
Laparoscopic cholecystectomy is a widely accepted procedure
that causes less postoperative pain and a shorter postoperative
length of stay (LoS) than open surgery. 4–8 Traditional laparoscopic Since 1985, many efforts have been on in the laparoscopy
cholecystectomy is done in >90% of elective cholecystectomies field to reduce the invasiveness of laparoscopic approaches, with
and 70% of urgent cholecystectomies. 9,10 operators developing new technology and techniques to minimize
The concept of SILS is to do the procedure through a single postoperative pain and improve esthetic outcome by small-sized
skin incision, usually the umbilicus through multichannel (trocar) ports or smaller numbers. At present, SILS has gained tremendous
ports. The umbilicus is the common site for basic procedures such focus for the treatment of many surgical diseases. 5,15–17
as laparoscopic cholecystectomy and appendectomy. The incision The difficulties of SILS include limited triangulation between
can be periumbilical or transumbilical. 11,12 straight instruments, restricted movements, close proximity
SILS is a quickly growing procedure as a union between traditional between the instruments, and narrow visual axis and operative
laparoscopic techniques and Natural orifice transluminal endoscopic field. 18–20
surgery (NOTES). The current trend has been about the development However, there are no clear indications for SILS until now,
of SILS to further reduce the invasiveness of laparoscopic surgeries and its applicability and feasibility have grown throughout many
by minimizing the number of skin violations. 13,14 of the surgical fields. The applicability of this approach has been

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