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Single port access (SPA) cholecystectomy: a completely transumbilical approach
Erica R Podolsky1, Steven J Rottman, Honesto Poblete
1Department of Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Summary
Single Port Access (SPA) surgery offers a new approach to cholecystectomy, utilizing the umbilicus for improved cosmesis. This minimally invasive technique is readily learned and performed by surgeons, achieving scar reduction.
Area of Science:
- Minimally Invasive Surgery
- Surgical Innovation
- Abdominal Surgery
Background:
- Minimally invasive surgery has evolved significantly, with recent advancements focusing on improved cosmesis and instrumentation.
- Natural orifice transluminal endoscopic surgery and robotics represent key developments in this field.
- Single Port Access (SPA) surgery emerges as a novel technique addressing these trends.
Purpose of the Study:
- To present and review the application of SPA surgery to cholecystectomy.
- To evaluate the feasibility and initial outcomes of SPA cholecystectomy.
- To highlight the cosmetic and technical advantages of SPA cholecystectomy.
Main Methods:
- Application of SPA technique to cholecystectomy in 5 consecutive patients.
- Procedure performed entirely through the umbilicus.
- Utilized standard laparoscopic cholecystectomy techniques.
Main Results:
- All 5 patients were female, average age 45, average weight 172 pounds.
- Indications included biliary dyskinesia and symptomatic cholelithiasis.
- Average operative time was 121 minutes; 4/5 patients discharged within 24 hours.
- No umbilical hernias observed at 6-month follow-up.
Conclusions:
- SPA cholecystectomy is a feasible technique for complete gallbladder removal.
- The procedure offers excellent cosmesis and scar reduction by utilizing a single umbilical incision.
- SPA cholecystectomy can be readily adopted by surgeons due to its reliance on established laparoscopic principles and lack of specialized equipment.