Introduction: The application of laparoscopy advanced General Surgery. Single Incision Laparoscopic Surgery may prove to be a further advancement, though currently an evolving concept. This study was undertaken to report our early experience with single incision laparoscopic cholecystectomy.Procedure: Cholecystectomies were carried out utilizing two 5mm ports placed through a single 1cm incision at the umbilicus. 5mm 0-degree or 30-degree laparoscopes were used. Sutures were placed into the gallbladder to facilitate extirpation. Gallbladders were removed through the umbilicus. Data are presented as median, mean + SD, where appropriate.
Results: Nine patients, six males and three females, of median age 45 years, 43 + 16 and median BMI of 27 kg/m2, 27 + 3.7, underwent single incision laparoscopic cholecystectomy. No patients undergoing attempted single incision cholecystectomies had conversions to “open” operations. Duration of operations was 73 minutes, 71 + 14.1. No intraoperative inadvertent events or complications occurred. Intraoperative blood loss was minimal. All patients had documented cholelithiasis and chronic cholecystitis. One patient experienced significant nausea and pain postoperatively, leading to a 3-day hospital stay. Eight patients were discharged within 23 hours.
Conclusions: Single incision laparoscopic cholecystectomy is feasible and safe, though it may require more time than conventional laparoscopic cholecystectomy. While many parameters of laparoscopic cholecystectomy are not notably impacted by single incision laparoscopic cholecystectomy, cosmesis and patient satisfaction is subjectively improved. Realistically, randomized trials comparing laparoscopic cholecystectomy to single incision laparoscopic cholecystectomy will doubtfully be undertaken. Nonetheless, single incision laparoscopic cholecystectomy will be embraced by consumers. Laparoscopic surgeons need to become proficient in Single Incision Laparoscopic Surgery to meet consumer demand.