Laparoendoscopic single site (LESS) versus classic video-laparoscopic cholecystectomy: a randomized prospective study

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Laparoscopic cholecystectomy (LC) is the standard treatment for gallstones.
• Laparoendoscopic single-site surgery (LESS) is emerging for gallstone treatment.
• Limited randomized trials compare LESS to traditional LC.

Purpose of the Study:

• To evaluate the feasibility and safety of LESS cholecystectomy.
• To compare LESS cholecystectomy with classic laparoscopic cholecystectomy.
• To assess patient outcomes including operative time, hospital stay, pain, and wound satisfaction.

Main Methods:

• Prospective randomized study comparing three-port LC (n=25) and LESS (n=25).
• Exclusion criteria included prior abdominal surgery, acute cholecystitis, choledocholithiasis, pancreatitis, ASA grade III+, BMI ≥ 30.
• Data collected: operative time, hospital stay, postoperative pain, and wound satisfaction scores.

Main Results:

• No significant differences in demographics, hospital stay, or postoperative pain.
• Mean operative time was longer for LESS (41.3 min) vs. LC (35.6 min) (P=0.04).
• Patients reported significantly higher wound satisfaction with LESS due to a single umbilical incision.

Conclusions:

• LESS cholecystectomy is a viable alternative to traditional LC for uncomplicated gallstone disease.
• LESS offers comparable hospital stay and pain management to LC.
• LESS significantly enhances patient wound satisfaction compared to traditional LC.