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KMID : 1035920170200020063
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Journal of Minimally Invasive Surgery
2017 Volume.20 No. 2 p.63 ~ p.68
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Single Incision Laparoscopic Cholecystectomy without a Camera Operator
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Choi Young-Rok
Ha Ho-Seong
Yoon Yoo-Seok
Cho Jae-Young
Jang Jae-Yool
Choi Han-lim
Jang Jae-Seong
Kwon Seong-Uk
Kim Sung-Ho
Choi Jang-Kyu
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Abstract
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Purpose:
This study aimed to evaluate the implementation of solo surgery using a laparoscopic scope holder for single incision laparoscopic cholecystectomy (SILC).
Methods: With a glove port and a flexible high-definition scope, SILC was performed through a single trans-umbilical incisional site with CO2 pneumoperitoneum at a pressure of 12 mmHg. Fifty-eight patients who underwent solo SILC using a scope holder (Solo-SILC) were compared to 15 patients who underwent camera operator-assisted SILC (Ca-SILC) in terms of intraoperative and postoperative outcomes.
Results: The mean BMI and operation time were 23.0-3.6 kg/m2 and 64.4-16.6 min in Ca-SILC and 25.0-3.8 kg/m2 and 58.2-27.1 min in Solo-SILC, respectively (p=0.067 and p=0.410). Estimated blood loss was negligible and an additional assistant port was not required in either groups. A case of gallbladder perforation and bile leak was noted in the Ca-SILC group, and 13 cases of bile leak in the Solo-SILC group, with no significant differences (p=0.167) during the surgery. Postoperative outcomes including surgical complications, diet restriction, diarrhea and hospital stay were not significantly different except for shoulder pain (p<0.001).
Conclusion: Even with the limitations of a small number of patients, Solo-SILC proved to be a feasible technique. To confirm the safety of solo-SILC, further studies with a larger sample size are required.
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KEYWORD
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Laparoscopic cholecystectomy, Surgical wound, Minimally invasive surgical procedures
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