Evaluating systemic stress response in single port vs. multi-port laparoscopic cholecystectomy

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Inflammation and Stress Response

Background:

• Surgical trauma elicits systemic stress responses, measured by acute-phase proteins and inflammatory cytokines.
• These responses correlate with the extent of tissue injury and post-operative outcomes.
• Comparing multi-port (LC) and single-incision laparoscopic cholecystectomy (SILC) can elucidate the impact of incision size on the stress response.

Purpose of the Study:

• To compare the systemic stress response following single-incision laparoscopic cholecystectomy (SILC) versus multi-port laparoscopic cholecystectomy (LC).
• To determine if a reduced incision size in SILC leads to a diminished stress response compared to LC.
• To evaluate post-operative outcomes including length-of-stay and morbidity.

Main Methods:

• A comparative study involving 35 patients: 11 undergoing SILC and 24 undergoing LC.
• Primary endpoints: pre- and post-operative levels of interleukin-6 and C-reactive protein.
• Secondary endpoints: length-of-stay (LOS) and postoperative morbidity.

Main Results:

• No statistically significant differences were observed between SILC and LC groups for interleukin-6 and C-reactive protein levels.
• Length-of-stay and duration of surgery also showed no significant differences between the two techniques.
• No correlation was found between the systemic stress response and operative parameters; no intra-operative complications occurred.

Conclusions:

• Single-incision laparoscopic cholecystectomy (SILC) is a safe and feasible surgical technique.
• SILC offers potential advantages such as improved cosmesis, reduced incisional pain, and enhanced patient well-being.
• Current data indicate no significant difference in systemic stress or morbidity between SILC and LC, warranting larger, multi-center trials.