Single Port Access Laparoscopic Cholecystectomy (with video)

Bucher, Pascal; Pugin, François; Buchs, Nicolas; Ostermann, Sandrine; Charara, Fadi; Morel, Philippe
May 2009
World Journal of Surgery;May2009, Vol. 33 Issue 5, p1015
Academic Journal
Single port access (SPA) surgery is a rapidly evolving field due to the complexity of NOTES (natural orifice translumenal endoscopic surgery). SPA combines the cosmetic advantage of NOTES and possibility to perform surgical procedure with standard laparoscopic instruments. We report a technique of umbilical SPA cholecystectomy using standard laparoscopic instruments and complying with conventional surgical principle and technique of minimally invasive cholecystectomy. Preliminary, prospective experience of SPA cholecystectomy in 11 patients (median age, 46 (range, 27–63) years) scheduled for cholecystectomy was evaluated. Diagnoses for cholecystectomy were: symptomatic gallbladder lithiasis ( n = 7), previous acute cholecystitis ( n = 3), and biliary pancreatitis ( n = 1). SPA cholecystectomy was feasible in all patients (median body mass index, 24 (range, 20–34) kg/m2) who were scheduled for preliminary experience using conventional laparoscopic instruments. Median operative time was 52 (range, 40–77) minutes. Intraoperative cholangiography was performed in all patients, except one, and was considered normal. No peroperative or postoperative complications were recorded. Median hospital stay was less than 24 h. SPA cholecystectomy is feasible and seems to be safe when performed by experienced laparoscopic surgeons using standard laparoscopic instrumentation. SPA cholecystectomy may be safer than the NOTES approach at this time. It has to be determined whether this approach would benefit patients, other than cosmesis, compared with standard laparoscopic cholecystectomy.


Related Articles

  • Single-Port in der Gallenblasenchirurgie. Langwieler, T. E.; Back, M. // Der Chirurg;May2011, Vol. 82 Issue 5, p406 

    Single-port access surgery (SPA), the most recent development in laparoscopic surgery allows operations to be carried out through only a single incision using special multichannel ports. By the use of a smaller access tissue trauma and access-related complications, such as wound infections,...

  • Multicenter study addresses complication rates with instrumented MIS spine surgery. Rapp, Susan M.; Sell, Philip J. // Orthopaedics Today Europe;May/Jun2011, Vol. 14 Issue 3, p10 

    The article provides information on a study which assessed the complication rate after posterior minimally invasive spinal (MIS) procedures.

  • Natural orifice surgery: initial clinical experience. Horgan, Santiago; Cullen, John P.; Talamini, Mark A.; Mintz, Yoav; Ferreres, Alberto; Jacobsen, Garth R.; Sandler, Bryan; Bosia, Julie; Savides, Thomas; Easter, David W.; Savu, Michelle K.; Ramamoorthy, Sonia L.; Whitcomb, Emily; Agarwal, Sanjay; Lukacz, Emily; Dominguez, Guillermo; Ferraina, Pedro // Surgical Endoscopy;Jul2009, Vol. 23 Issue 7, p1512 

    Natural orifice translumenal endoscopic surgery (NOTES) has moved quickly from preclinical investigation to clinical implementation. However, several major technical problems limit clinical NOTES including safe access, retraction and dissection of the gallbladder, and clipping of key structures....

  • Commentary on "SILS and NOTES cholecystectomy: a tailored approach". Smith, C. Daniel // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jul/Aug2010, Vol. 20 Issue 6, p514 

    Background: Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS) have been proposed as different solutions to further minimize the invasiveness of laparoscopy. In this article, we present our experience with NOTES and SILS over the last few...

  • Mortality Associated with the Treatment of Gallstone Disease: A 10-Year Contemporary National Experience. Scollay, John M.; Mullen, Russell; McPhillips, Gillian; Thompson, Alastair M. // World Journal of Surgery;Mar2011, Vol. 35 Issue 3, p643 

    Background: Gallstones remain a common clinical problem requiring skilled operative and nonoperative management. The aim of the present population-based study was to investigate causes of gallstone-related mortality in Scotland. Methods: Surgical deaths were peer reviewed between 1997 and 2006...

  • Frequency of Bile Leak after Laparoscopic Cholecystectomy: Audit of a Surgical Residency Program. Paajanen, Hannu; Suuronen, Satu; Eskelinen, Matti; Hytonen, Santtu; Juvonen, Petri // American Surgeon;Jan2014, Vol. 80 Issue 1, p91 

    This article reports on a study which analyzed the diagnostic delay, frequency and outcome of bile leaks after laparoscopic cholecystectomy (LC). Findings revealed that the incidence of bile leaks was 14 of 1,895. It is also noted that bile leaks were more frequently associated with longer...

  • Single-trocar cholecystectomy using a flexible endoscope and articulating laparoscopic instruments: a bridge to NOTES or the final form? Elazary, Ram; Khalaileh, Abed; Zamir, Gideon; Har-Lev, Michael; Almogy, Gidon; Rivkind, Avraham I.; Mintz, Yoav // Surgical Endoscopy;May2009, Vol. 23 Issue 5, p969 

    NOTES cholecystectomy, may eliminate complications related to abdominal incisions. However, the nonmandatory gastrotomy and its safe closure is the main controversy accompanying this approach. Transvaginal access has minimal closure consequences but the safety of inserting extralong instruments...

  • Single-Port Cholecystectomy Versus Multi-Port Cholecystectomy: A Prospective Cohort Study with 222 Patients. Wagner, Markus; Kern, Hans; Hapfelmeier, Alexander; Mehler, Jan; Schoenberg, Michael // World Journal of Surgery;May2013, Vol. 37 Issue 5, p991 

    Background: The aim of this study was to compare single-port access cholecystectomy (SPA) with the standard laparoscopic technique (LC) regarding the duration of the operation, complications, learning curve, late postoperative quality of life (QoL) and the incidence of incisional hernias....

  • Predicting major complications after laparoscopic cholecystectomy: a simple risk score. Murphy, Melissa M.; Shah, Shimul A.; Simons, Jessica P.; Csikesz, Nicholas G.; McDade, Theodore P.; Bodnari, Andreea; Sing-Chau Ng; Zheng Zhou; Tseng, Jennifer F.; Ng, Sing-Chau; Zhou, Zheng // Journal of Gastrointestinal Surgery;Nov2009, Vol. 13 Issue 11, p1929 

    Introduction: Reported morbidity varies widely for laparoscopic cholecystectomy (LC). A reliable method to determine complication risk may be useful to optimize care. We developed an integer-based risk score to determine the likelihood of major complications following...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics