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A specific instrument to facilitate single-incision laparoscopic cholecystectomy: an initial experience
Heliang Yin1, Zhifei Wang, Jun Xu
1Harbin Medical University, Harbin, China.
Background:
Single-incision laparoscopic cholecystectomy (SILC) is a promising technique with regard to reducing postoperative pain, decreasing complications, and improving cosmesis. Many instruments have been invented to overcome the limitation brought about by the chopstick effect, most of which are inflexible. This results in a limitation when the operator wants to move the tip of the instrument to a certain angle. Recently, the authors used a new instrument, which has 2 simultaneously movable wrists, in 30 cases of SILC.
Methods:
From May 2010 to August 2010, 30 patients with symptomatic gallbladder disease underwent SILC through a 15- to 20-mm umbilical incision using a 3-trocar technique. A novel laparoscope instrument with adjustable and rotatable wrists (Liuyedao, Inc, Yuyao,China) was applied, combined with the use of harmonic scalpel.
Results:
The mean operation time was 56.4 minutes (range = 26-170 minutes). The mean estimated blood loss was 16.6 mL (range = 5-60 mL). There were no conversions of the SILC technique. No drainage was placed, and no bleeding or bile leakage occurred. The mean hospital stay was 3 days (range = 1-5 days).
Conclusions:
The SILC technique with the novel instrument is safe, feasible, and effective. This new instrument facilitates the SILC procedure.