A prospective controlled trial comparing single-incision and conventional laparoscopic cholecystectomy: caution...

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Laparoscopic cholecystectomy is the standard treatment for gallstones.
• Single-incision laparoscopic cholecystectomy (SILS-C) offers potential cosmetic and ergonomic benefits.
• Evaluating SILS-C's safety and feasibility compared to conventional laparoscopic cholecystectomy (CLC) is crucial.

Purpose of the Study:

• To compare the safety and feasibility of SILS-C versus CLC.
• To assess postoperative outcomes including pain, nausea, and recovery.
• To identify potential complications associated with SILS-C.

Main Methods:

• Prospective study of 65 patients undergoing SILS-C (35) or CLC (30) using conventional instruments.
• Data collection included postoperative pain, nausea, vomiting, oral intake, hospital stay, and return to activities.
• Morbidity parameters and patient satisfaction were compared between the two groups.

Main Results:

• Twenty-eight percent of SILS-C patients required additional trocars; no conversions to open surgery occurred.
• Postoperative morbidity was similar, except for a significantly higher incidence of wound seroma in the SILS-C group (17% vs 0%).
• One case of major bile duct injury was reported in the SILS-C group.

Conclusions:

• SILS-C is a safe and feasible option when performed with conventional laparoscopic instruments.
• Higher rates of seroma formation and the risk of bile duct injury warrant careful consideration.
• Further research may be needed to optimize SILS-C techniques and patient selection.