Original Article

J Minim Invasive Surg 2015; 18(2): 44-47

Published online June 15, 2015

https://doi.org/10.7602/jmis.2015.18.2.44

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

Transumbilical Laparoscopic Cholecystectomy with Additional Port: A Single Surgeon’s Experience with 291 Cases

Ji Woong Hwang, M.D., Byoung Yoon Ryu, Ph.D.

Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University Medical Center,Chuncheon, Korea

Received: October 16, 2014; Revised: December 16, 2014; Accepted: January 27, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose: Single-port laparoscopic cholecystectomy may result in postoperative complication in patients with cholecystitis. An additional right subcostal port could make laparoscopic surgery safe in these patients. We suggest the transumbilical laparoscopic cholecystectomy with additional port, which can be performed safely regardless of cholecystitis. Methods: Consecutive 291 patients underwent transumbilical laparoscopic cholecystectomy in the Department of Surgery by a single surgeon. We have usually used the globe port in the transumbilical area and an additional right subcostal port. Results: The mean operation time was 44.0±15.2 min (range: 20-140). The mean hospital stay after operation was 4.0±2.3 days (range: 1-9). Postoperative complications were umbilical hernia (n=7) and bile leakage (n=3). There was no in-hospital mortality. Conclusion: Transumbilical laparoscopic cholecystectomy can be performed in patients with most of benign gallbladder disease. And, an additional right subcostal port could be helpful in ensuring safe transumbilical laparoscopic cholecystectomy, even in patients with cholecystitis.

Keywords Laparoscopy, Cholecystectomy, Cholecystitis

  1. Hu H, Xu AA, Huang A. Towards scarless surgery: a novel laparoscopic cholecystectomy by using 2-mm needle-shape instruments without trocar. J Laparoendosc Adv Surg Tech A 2013;23:698-701.
    Pubmed CrossRef
  2. Marks JM, Phillips MS, Tacchino R, et al. Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg 2013;216:1037-1047; discussion 1047-1038.
  3. Cheng Y, Jiang ZS, Xu XP, et al. Laparoendoscopic single-site cholecystectomy vs three-port laparoscopic cholecystectomy: a large-scale retrospective study. World J Gastroenterol 2013;19:4209-4213.
    Pubmed KoreaMed CrossRef
  4. Uras C, Boler DE. Endoloop retraction technique in single-port laparoscopic cholecystectomy: experience in 27 patients. J Laparoendosc Adv Surg Tech A 2013;23:545-548.
    Pubmed CrossRef
  5. Ito M, Asano Y, Horiguchi A, et al. Cholecystectomy using single-incision laparoscopic surgery with a new SILS port. J Hepatobiliary Pancreat Sci 2010;17:688-691.
    Pubmed CrossRef
  6. Hirano Y, Watanabe T, Uchida T, et al. Single-incision laparoscopic cholecystectomy: single institution experience and literature review. World J Gastroenterol 2010;16:270-274.
    Pubmed KoreaMed CrossRef
  7. Cao ZG, Cai W, Qin MF, Zhao HZ, Yue P, Li Y. Randomized clinical trial of single-incision versus conventional laparoscopic cholecystectomy: short-term operative outcomes. Surg Laparosc Endosc Percutan Tech 2011;21:311-313.
    Pubmed CrossRef
  8. Zapf M, Yetasook A, Leung D, et al. Single-incision results in similar pain and quality of life scores compared with multiincision laparoscopic cholecystectomy: A blinded prospective randomized trial of 100 patients. Surgery 2013;154:662-671.
    Pubmed CrossRef
  9. Uecker JM, Lopez DE. Single-incision Laparoscopic Cholecystectomy: No Benefit Over Conventional Laparoscopic Cholecystectomy. Am Surg 2013;79:1227-1230.
    Pubmed
  10. Hwang HK, Choi SH, Kang CM, Lee WJ. Single-fulcrum laparoscopic cholecystectomy in uncomplicated gallbladder diseases: a retrospective comparative analysis with conventional laparoscopic cholecystectomy. Yonsei Med J 2013;54:1471-1477.
    Pubmed KoreaMed CrossRef
  11. Carus T. Current advances in single-port laparoscopic surgery. Langenbecks Arch Surg 2013;398:925-929.
    Pubmed CrossRef
  12. Vidal O, Valentini M, Ginesta C, et al. Single-incision versus standard laparoscopic cholecystectomy: comparison of surgical outcomes from a single institution. J Laparoendosc Adv Surg Tech A 2011;21:683-686.
    Pubmed CrossRef
  13. Fronza JS, Linn JG, Nagle AP, Soper NJ. A single institution's experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy. Surgery 2010;148:731734; discussion 734-736.
    Pubmed CrossRef
  14. Abdel Azeez T, Mahran KM. Transumbilical laparoscopic cholecystectomy:towards a scarless abdominal surgery. Hepatogastroenterology 2011;58:298-300.
    Pubmed
  15. Pan MX, Liang ZW, Cheng Y, et al. Learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy. World J Gastroenterol 2013;19:4786-4790.
    Pubmed KoreaMed CrossRef
  16. Ikeda N, Ueno M, Kanamura T, et al. Safety and feasibility for single-incision laparoscopic cholecystectomy in local community hospital: a retrospective comparison with conventional 4-port laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2013;23:33-36.
    Pubmed CrossRef
  17. Alptekin H, Yilmaz H, Acar F, Kafali ME, Sahin M. Incisional hernia rate may increase after single-port cholecystectomy. J Laparoendosc Adv Surg Tech A 2012;22:731-737.
    Pubmed CrossRef
  18. Krajinovic K, Ickrath P, Germer CT, Reibetanz J. Trocar-site hernia after single-port cholecystectomy: not an exceptional complication? J Laparoendosc Adv Surg Tech A 2011;21:919-921.
    Pubmed CrossRef
  19. Agaba EA, Rainville H, Ikedilo O, Vemulapali P. Incidence of port-site incisional hernia after single-incision laparoscopic surgery. JSLS 2014;18:204-210.
    Pubmed KoreaMed CrossRef
  20. Yilmaz H, Alptekin H, Acar F, Calisir A, Sahin M. Single-incision laparoscopic cholecystectomy and overweight patients. Obes Surg 2014;24:123-127.
    Pubmed CrossRef

Article

Original Article

J Minim Invasive Surg 2015; 18(2): 44-47

Published online June 15, 2015 https://doi.org/10.7602/jmis.2015.18.2.44

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

Transumbilical Laparoscopic Cholecystectomy with Additional Port: A Single Surgeon’s Experience with 291 Cases

Ji Woong Hwang, M.D., Byoung Yoon Ryu, Ph.D.

Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University Medical Center,Chuncheon, Korea

Received: October 16, 2014; Revised: December 16, 2014; Accepted: January 27, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Single-port laparoscopic cholecystectomy may result in postoperative complication in patients with cholecystitis. An additional right subcostal port could make laparoscopic surgery safe in these patients. We suggest the transumbilical laparoscopic cholecystectomy with additional port, which can be performed safely regardless of cholecystitis. Methods: Consecutive 291 patients underwent transumbilical laparoscopic cholecystectomy in the Department of Surgery by a single surgeon. We have usually used the globe port in the transumbilical area and an additional right subcostal port. Results: The mean operation time was 44.0±15.2 min (range: 20-140). The mean hospital stay after operation was 4.0±2.3 days (range: 1-9). Postoperative complications were umbilical hernia (n=7) and bile leakage (n=3). There was no in-hospital mortality. Conclusion: Transumbilical laparoscopic cholecystectomy can be performed in patients with most of benign gallbladder disease. And, an additional right subcostal port could be helpful in ensuring safe transumbilical laparoscopic cholecystectomy, even in patients with cholecystitis.

Keywords: Laparoscopy, Cholecystectomy, Cholecystitis

References

  1. Hu H, Xu AA, Huang A. Towards scarless surgery: a novel laparoscopic cholecystectomy by using 2-mm needle-shape instruments without trocar. J Laparoendosc Adv Surg Tech A 2013;23:698-701.
    Pubmed CrossRef
  2. Marks JM, Phillips MS, Tacchino R, et al. Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg 2013;216:1037-1047; discussion 1047-1038.
  3. Cheng Y, Jiang ZS, Xu XP, et al. Laparoendoscopic single-site cholecystectomy vs three-port laparoscopic cholecystectomy: a large-scale retrospective study. World J Gastroenterol 2013;19:4209-4213.
    Pubmed KoreaMed CrossRef
  4. Uras C, Boler DE. Endoloop retraction technique in single-port laparoscopic cholecystectomy: experience in 27 patients. J Laparoendosc Adv Surg Tech A 2013;23:545-548.
    Pubmed CrossRef
  5. Ito M, Asano Y, Horiguchi A, et al. Cholecystectomy using single-incision laparoscopic surgery with a new SILS port. J Hepatobiliary Pancreat Sci 2010;17:688-691.
    Pubmed CrossRef
  6. Hirano Y, Watanabe T, Uchida T, et al. Single-incision laparoscopic cholecystectomy: single institution experience and literature review. World J Gastroenterol 2010;16:270-274.
    Pubmed KoreaMed CrossRef
  7. Cao ZG, Cai W, Qin MF, Zhao HZ, Yue P, Li Y. Randomized clinical trial of single-incision versus conventional laparoscopic cholecystectomy: short-term operative outcomes. Surg Laparosc Endosc Percutan Tech 2011;21:311-313.
    Pubmed CrossRef
  8. Zapf M, Yetasook A, Leung D, et al. Single-incision results in similar pain and quality of life scores compared with multiincision laparoscopic cholecystectomy: A blinded prospective randomized trial of 100 patients. Surgery 2013;154:662-671.
    Pubmed CrossRef
  9. Uecker JM, Lopez DE. Single-incision Laparoscopic Cholecystectomy: No Benefit Over Conventional Laparoscopic Cholecystectomy. Am Surg 2013;79:1227-1230.
    Pubmed
  10. Hwang HK, Choi SH, Kang CM, Lee WJ. Single-fulcrum laparoscopic cholecystectomy in uncomplicated gallbladder diseases: a retrospective comparative analysis with conventional laparoscopic cholecystectomy. Yonsei Med J 2013;54:1471-1477.
    Pubmed KoreaMed CrossRef
  11. Carus T. Current advances in single-port laparoscopic surgery. Langenbecks Arch Surg 2013;398:925-929.
    Pubmed CrossRef
  12. Vidal O, Valentini M, Ginesta C, et al. Single-incision versus standard laparoscopic cholecystectomy: comparison of surgical outcomes from a single institution. J Laparoendosc Adv Surg Tech A 2011;21:683-686.
    Pubmed CrossRef
  13. Fronza JS, Linn JG, Nagle AP, Soper NJ. A single institution's experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy. Surgery 2010;148:731734; discussion 734-736.
    Pubmed CrossRef
  14. Abdel Azeez T, Mahran KM. Transumbilical laparoscopic cholecystectomy:towards a scarless abdominal surgery. Hepatogastroenterology 2011;58:298-300.
    Pubmed
  15. Pan MX, Liang ZW, Cheng Y, et al. Learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy. World J Gastroenterol 2013;19:4786-4790.
    Pubmed KoreaMed CrossRef
  16. Ikeda N, Ueno M, Kanamura T, et al. Safety and feasibility for single-incision laparoscopic cholecystectomy in local community hospital: a retrospective comparison with conventional 4-port laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2013;23:33-36.
    Pubmed CrossRef
  17. Alptekin H, Yilmaz H, Acar F, Kafali ME, Sahin M. Incisional hernia rate may increase after single-port cholecystectomy. J Laparoendosc Adv Surg Tech A 2012;22:731-737.
    Pubmed CrossRef
  18. Krajinovic K, Ickrath P, Germer CT, Reibetanz J. Trocar-site hernia after single-port cholecystectomy: not an exceptional complication? J Laparoendosc Adv Surg Tech A 2011;21:919-921.
    Pubmed CrossRef
  19. Agaba EA, Rainville H, Ikedilo O, Vemulapali P. Incidence of port-site incisional hernia after single-incision laparoscopic surgery. JSLS 2014;18:204-210.
    Pubmed KoreaMed CrossRef
  20. Yilmaz H, Alptekin H, Acar F, Calisir A, Sahin M. Single-incision laparoscopic cholecystectomy and overweight patients. Obes Surg 2014;24:123-127.
    Pubmed CrossRef

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