Prospective randomized comparison of single-incision laparoscopic cholecystectomy with new facilitator maneuver vs. conventional four-port
Recep Aktimur1, Kerim Guzel2, Süleyman Çetinkunar3, Kadir Yıldırım1, Elif Çolak1
1Clinic of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey
2Department of General Surgery, Samsun Private Great Anatolia Hospital, Samsun, Turkey
3Clinic of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
Abstract
Objective: We aimed to investigate the technical feasibility of single-incision laparoscopic cholecystectomy (SILC) with our new facilitator maneuver and to compare it with gold standart four-port laparoscopic cholecystectomy (LC).
Material and Methods: Operation times, cosmesis score and incisional hernia rate between LC (n=20) and SILC-1 (first 20 consecutive operations of new technique) and 2 (following 20 operations of new technique) were compared.
Results: Median operation time for LC, SILC-1 and SILC-2 were; 35 min (12-75), 47.5 min (30-70), and 30 min (12-80), respectively (p=0.005). Operation time was similar in LC and SILC-2 (p=0.277). Wound seroma was higher in SILC-1 (45%), SILC-2 (30%) groups than LC (5%) group (p=0.010). Cosmesis score was similar between the groups. Hernia rates were 15.8% and 5.3% in SILC-1 and SILC-2 groups, while in LC group there was no hernia.
Conclusion: SILC with new facilitator maneuver is comparable with classical four-port laparoscopic cholecystectomy, in terms of ease, operation time, reproducibility and safety. Beside these advantages, before we recommend it to the patients, single-incision access technique must be optimized to provide comparable wound complication and postoperative hernia rates.
Keywords: Single-incision, conventional, laparoscopic, cholecystectomy, technique
An approval was obtained for this study from the ethics committee of Samsun Training and Research Hospital (No: 2014/551).
Written informed consent was obtained from patients who participated in this study.
Externally peer-reviewed.
Concept - R.A.; Design - R.A., K.G.; Supervision - E.Ç.; Resources - S.Ç., K.Y.; Materials - K.Y.; Data Collection and/or Processing - R.A., K.Y.; Analysis and/or Interpretation - R.A., K.G., S.Ç., K.Y., E.Ç.; Literature Search - R.A., D.Ç., E.Ç.; Writing Manuscript - R.A.; Critical Review - R.A., K.G., S.Ç., K.Y., E.Ç.; Other - R.A., K.G., S.Ç., K.Y., E.Ç.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.