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Single-port access in laparoscopic cholecystectomy
Thomas E Langwieler1, Thomas Nimmesgern, Melanie Back
1Department of General and Visceral Surgery and Minimally Invasive Surgery, Ev Amalie Sieveking-Hospital, Hamburg, Germany. t.e.langwieler@amalie.de
Background:
Single-port access cholecystectomy is a new laparoscopic procedure using only one, transumbilical-placed port. The method has been denominated by some authors as "scarless." We report one of the initial clinical experiences in Europe with this new technique.
Methods:
Fourteen patients underwent laparoscopic cholecystectomy using the ASC TriPort. In all cases, a small transumbilical incision was used to insert two 5-mm rigid laparoscopic instruments and a 5-mm 30 degrees telescope via the Triport. Hemostasis control was obtained by using an ultrasonic cutting device (SonoSurg, Olympus), Endo Clips (Covidien), and Lapro-Clips (Covidien).
Results:
All cases were completed successfully. There were no perioperative port-related or surgical complications. No extra skin incisions were needed. Operative time was longer than in common laparoscopic cholecystectomy.
Conclusions:
Transumbilical single-port access cholecystectomy (SPACE) is a feasible technique for operating with less scars and reducing postoperative discomfort at the same time. The transumbilical single-port access for laparoscopic cholecystectomy has multiple benefits, such as better cosmetic results, less wound infections, and less incisional hernias. That is why SPACE is even more appropriate for obese patients. Using one-hand specialized instruments, which are curved at the shaft, and a semiflexible laparoscopic camera (LTFVH, Olympus) will make SPACE more comfortable and more time-saving.