Single incision vs. conventional multiport laparoscopic cholecystectomy: a comparison of two approaches

Laparoscopic techniques are rapidly evolving and trends towards a more minimally invasive approach have led to the introduction of single incision and natural orifice laparoscopic surgery. The aim of this study was to compare the outcomes of single-incision laparoscopic cholecystectomy (SILC) to conventional multiport laparoscopic cholecystectomy (MPLC). We compared intra-operative complications, operative time, postoperative complications, pain score, readmission rate and conversion to open amongst both groups.

A retrospective review of data of patients who underwent laparoscopic cholecystectomy between May 2009 and November 2011 was performed. All procedures were performed by a single surgeon.

A total of 184 patients underwent laparoscopic cholecystectomy. 76 patients from MPLC were excluded from comparison based on exclusion criteria. The remaining 62 patients in MPLC and 45 patients in the SILC group were compared. The two groups were similar with respect to patients' demographics and American Society of Anaesthesiology grades. The median operative time for SILC was 75 min (range 42-120) compared to 60 min (range 26-117) in MPLC (p = 0.02). There was no conversion to open procedure. One patient in SILC group was converted to MPLC and two patients required a second port insertion. Postoperative pain-score and length of hospital stay were comparable in both groups. One patient in each group had minor bleeding from gall bladder bed controlled with diathermy.

SILC is a safe and feasible approach in selected patients. There was no difference in complication rate amongst the two approaches with a longer operative time in the SILC approach.