Original Article

J Minim Invasive Surg 2011; 14(2): 51-55

Published online December 15, 2011

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

단일 지렛대 원리를 이용한 단일통로 복강경 담낭절제술: 변형된 단일절개, 다투관침 방법

장지영1ㆍ최성훈1,2ㆍ황호경1,2ㆍ강창무1,2ㆍ이우정1,2

1연세대학교 의과대학 세브란스병원 외과학교실, 2연세대학교 의과대학 세브란스병원 외과학교실 간담췌외과

Single-fulcrum Laparoscopic Cholecystectomy: A Variant Type of Single Incision and Multiport Technique

Ji Young Jang, M.D.1, Sung Hoon Choi, M.D.1,2, Ho Kyoung Hwang, M.D.1,2, Chang Moo Kang, M.D.1,2, Woo Jung Lee, M.D., Ph.D.1,2

1Department of Surgery, Yonsei University College of Medicine, 2Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Several techniques and devices have recently been introduced for single-incision laparoscopic cholecystectomy. We describe our technique using standard laparoscopic instruments and ports, and report the initial results.
Methods: Between March 2009 and June 2010, 60 consecutive patients underwent single-fulcrum laparoscopic cholecystectomy for benign gallbladder disease. The general patient characteristics and perioperative results, including the operation time, conversion rate and complications, were assessed retrospectively.
Results: Seventeen (28.3%) patients were male and 43 (71.7%) patients were female. The mean age was 47.4±12.4 years, and the mean total operation time was 57.5±13.9 min. The operation time became stable after 30 cases. There was no conversion to conventional laparoscopic cholecystectomy or open surgery. Additional trocars were required in three patients due to intraoperative complications, which weremanaged successfully with additional trocars. The intraoperative complications included loosening of the clips on the cystic duct, vertical laceration of the cystic duct, and burn injuries to the duodenal wall. There was no postoperative morbidity.
Conclusion: Despite the limited sample size in this series, the results suggest that single-fulcrum laparoscopic cholecystectomy is safe and feasible for the treatment of benign gallbladder disease. Nevertheless, a further prospective randomized controlled trial comparing this technique with conventional techniques will be needed to confirm its true clinical value.

Keywords Single incision, Single port, Cholecystectomy, Laparoscopic

Article

Original Article

J Minim Invasive Surg 2011; 14(2): 51-55

Published online December 15, 2011

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

단일 지렛대 원리를 이용한 단일통로 복강경 담낭절제술: 변형된 단일절개, 다투관침 방법

장지영1ㆍ최성훈1,2ㆍ황호경1,2ㆍ강창무1,2ㆍ이우정1,2

1연세대학교 의과대학 세브란스병원 외과학교실, 2연세대학교 의과대학 세브란스병원 외과학교실 간담췌외과

Single-fulcrum Laparoscopic Cholecystectomy: A Variant Type of Single Incision and Multiport Technique

Ji Young Jang, M.D.1, Sung Hoon Choi, M.D.1,2, Ho Kyoung Hwang, M.D.1,2, Chang Moo Kang, M.D.1,2, Woo Jung Lee, M.D., Ph.D.1,2

1Department of Surgery, Yonsei University College of Medicine, 2Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Several techniques and devices have recently been introduced for single-incision laparoscopic cholecystectomy. We describe our technique using standard laparoscopic instruments and ports, and report the initial results.
Methods: Between March 2009 and June 2010, 60 consecutive patients underwent single-fulcrum laparoscopic cholecystectomy for benign gallbladder disease. The general patient characteristics and perioperative results, including the operation time, conversion rate and complications, were assessed retrospectively.
Results: Seventeen (28.3%) patients were male and 43 (71.7%) patients were female. The mean age was 47.4±12.4 years, and the mean total operation time was 57.5±13.9 min. The operation time became stable after 30 cases. There was no conversion to conventional laparoscopic cholecystectomy or open surgery. Additional trocars were required in three patients due to intraoperative complications, which weremanaged successfully with additional trocars. The intraoperative complications included loosening of the clips on the cystic duct, vertical laceration of the cystic duct, and burn injuries to the duodenal wall. There was no postoperative morbidity.
Conclusion: Despite the limited sample size in this series, the results suggest that single-fulcrum laparoscopic cholecystectomy is safe and feasible for the treatment of benign gallbladder disease. Nevertheless, a further prospective randomized controlled trial comparing this technique with conventional techniques will be needed to confirm its true clinical value.

Keywords: Single incision, Single port, Cholecystectomy, Laparoscopic

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