Solo single incision laparoscopic cholecystectomy using the parallel method; Surgical technique reducing a steep...

Area of Science:

• Minimally Invasive Surgery
• Hepatobiliary Surgery
• Surgical Technique Innovation

Background:

• Single-incision laparoscopic cholecystectomy (SILC) aims to reduce surgical invasiveness.
• Solo-SILC utilizes a scope holder for a simplified approach.
• Evaluating the feasibility and learning curve of Solo-SILC is crucial for wider adoption.

Purpose of the Study:

• To detail the techniques and short-term outcomes of solo single-incision laparoscopic cholecystectomy (Solo-SILC).
• To assess the learning curve associated with Solo-SILC performed by experienced surgeons.
• To evaluate the safety and efficacy of Solo-SILC using a laparoscopic scope holder.

Main Methods:

• Retrospective analysis of 590 Solo-SILC procedures performed between July 2014 and December 2016.
• Four experienced hepatobiliary surgeons utilized the parallel technique with a scope holder.
• The moving average method was employed to analyze the operative time and learning curve.

Main Results:

• Solo-SILC demonstrated a low conversion rate to multi-port surgery.
• Mean operative time was comparable to or shorter than reported SILC procedures.
• A rapid learning curve was observed, with experienced surgeons mastering the technique quickly; one surgeon experienced a slight learning curve.
• One case of bile duct injury and three instances of bile leakage were reported and successfully managed.

Conclusions:

• Experienced laparoscopic surgeons can readily adopt Solo-SILC with minimal training.
• The parallel technique for Solo-SILC is a stable and effective method for gallbladder disease.
• Solo-SILC represents a promising advancement in minimally invasive gallbladder surgery.