SINGLE TRANS-UMBILICAL VERSUS MULTI-INCISION LAPAROSCOPIC CHOLECYSTECTOMY USING CONVENTIONAL LAPAROSCOPIC INSTRUMENTS; A RANDOMIZED CONTROLLED CLINICAL TRIAL | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 32, Issue 3, July 2013, Page 157-163 PDF (646.79 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2013.366727 | ||||
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| Authors | ||||
| Ahmed Talha* 1; Waleed Abo Elwafa2 | ||||
| 1Department of Surgery, Medical Research Institute | ||||
| 2Department of Surgery, Faculty of Medicine, Alexandria University, Egypt | ||||
| Abstract | ||||
| Summery Background data: Laparoscopic cholecystectomy has traditionally been performed using multiple incisions. Single-incision laparoscopic surgery has emerged as an alternative technique to improve cosmoses and minimize complications associated with multiple incisions. Objective: To compare the outcomes of single-incision laparoscopic cholecystectomy (SILC) versus multiincision laparoscopic cholecystectomy (MILC) using conventional laparoscopic instruments. Methods: 64 patients undergoing cholecystectomy for symptomatic gall stones, dyskinesia or polyp who were willing to be part of this comparison were included in the study. Patients were randomized into two groups of 32 per each. Only conventional instruments were used in both groups to keep the cost of surgery the same. No special ports, reticulating instruments or flexible telescopes were used. Results: Of the attempted SILC cases, 26 (81.25%) were successfully completed, with the remainder requiring one to three additional skin incisions. There were no conversions to open in either group. Operative time was significantly longer in SILC cases compared with MILC [65(45-120) Vs 40(25-70) P_ 0 .0001]. There was a tendency toward greater postoperative pain in the MILC group. No intra-operative complications but two cases of port site hernias reported two months post-operative in SILC group. Significant better cosmetic outcome was observed in SILC cases. Conclusion: SILC is feasible and promising. It is possible to do this procedure without using special equipment and could be an effective alternative to standard four-incision laparoscopic cholecystectomy. With the possibility that after the initial learning curve, when the operative time reduces, the postoperative pain may also decrease. More studies are needed to demonstrate safety, selection criteria and benefits over conventional laparoscopic cholecystectomy. | ||||
| Keywords | ||||
| Single incision Laparoscopic Cholecystectomy; Multi-incision; Conventional Laparoscopic Cholecystectomy; Trans-umbilical incision; SILS | ||||
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