Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2009 Jul-Sep;13(3):332-6.

The learning curve with single-port cholecystectomy

Amanda J Kravetz  1 , Douglas Iddings, Marc D Basson, Michael A Kia
Affiliations
Comparative Study

The learning curve with single-port cholecystectomy

Amanda J Kravetz et al. JSLS. 2009 Jul-Sep.

Abstract

Objectives: Single-port surgery is a rapidly advancing technique in laparoscopic surgery. Currently, there is limited evidence on the learning curve and practicality of performing single-port laparoscopic cholecystectomy.

Methods: Single-port cholecystectomy was performed on 20 consecutive patients for biliary dyskinesia, symptomatic cholelithiasis, or acute cholecystitis. The Tri-Port was placed in the umbilicus, and a combination of straight and articulating instruments were utilized. Patient characteristics and outcomes were reviewed, and a comparison was made with the prior 20 consecutive laparoscopic cholecystectomies performed using the 3-port technique.

Results: Characteristics were similar in both groups. The 3-port cholecystectomy had a mean time of 65.7 minutes, and patients had an average body mass index of 28.16. The first single-port cholecystectomy took 160 minutes with sequential improvement to the sixth case of 66 minutes with a mean of 68.2 minutes for the last 15 single-port cases. The average patient body mass index was 30.24. No major complications occurred.

Conclusion: The largest series to date of single-port cholecystectomy for multiple degrees of biliary disease is presented. This study validates that this technique can be applied effectively and performed in comparable operative times to traditional 3-port cholecystectomy with a learning curve of approximately 5 cases.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Placement of the Tri-Port.
Figure 2.
Figure 2.
Placement of surgical clip at the puncture point to prevent spillage of bile.
Figure 3.
Figure 3.
Operative times. Patient 9 had an intraoperative cholangiogram performed. Patients 10, 12, 14, and 16 had acute cholecystitis. Insert labels for figure 3: x-axis = Patient y-axis = Operative Time (min)
Figure 4.
Figure 4.
Comparison of single port cholecystectomy operating times versus 3-port cholecystectomy operating times. SPC = single port cholecystectomies; 3-Port = 3-port cholecystectomies. Insert labels for figure 4: y axis = Operating Time (min) × axis beneath bar 1 from the left = First 5 SPC × axis bar 2 = Last 15 SPC × axis bar 3 = Total SPC × axis bar 4 = 3-Port × axis bar 5 = Last 15 SPC × axis bar 6 = 3-Port
See this image and copyright information in PMC

References

    1. Piskun G, Rajpal S. Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech. 1999;9:361–364 - PubMed
    1. Rane A, Rao P, Rao P. Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-Port). Urology. 2008;72(2):260–264 - PubMed
    1. Desai MM, Rao PP, Aron M, Pascal-Haber G, Desai MR, Mishra S, Kaouk JH, Gill IS. Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int. 2008;101:83–88 - PubMed
    1. Romanelli JR, Mark L, Omotosho PA. Single port laparoscopic cholecystectomy with the triport system: a case report. Surg Innov. 2008;15:223–228 - PubMed
    1. Access-related complications – an analysis of 6023 consecutive laparoscopic hernia repairs. Minim Invasive Ther Allied Technol. 2001;10:23–29 - PubMed

Publication types

LinkOut - more resources