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Case Reports
. 2019 Jul-Sep;23(3):e2018.00102.
doi: 10.4293/JSLS.2018.00102.

Laparoscopic Single-Port Versus Traditional Multi-Port Laparoscopic Cholecystectomy

Marco Casaccia  1 , Denise Palombo  1 , Andrea Razzore  1 , Emma Firpo  1 , Fabio Gallo  2 , Rosario Fornaro  1
Affiliations
Case Reports

Laparoscopic Single-Port Versus Traditional Multi-Port Laparoscopic Cholecystectomy

Marco Casaccia et al. JSLS. 2019 Jul-Sep.

Abstract

Background and objectives: Safety, efficacy, and costs are still debated issues in single-port laparoscopy. The aim of the study was to compare clinical outcomes and hospital costs for conventional 4-port laparoscopic cholecystectomy (4PLC) and single-port laparoscopic cholecystectomy (SPLC) performed at a single institution.

Methods: A series of 40 SPLC patients operated on from October 2016 to May 2017 were compared to a hystorical series of 40 4PLC patients. Primary endpoints were the operative time, blood loss, postoperative pain, analgesia requirement, length of stay, and morbidity. Secondary endpoints were the operative costs and total hospital costs.

Results: No patient required surgical conversion in both groups. Duration of surgery was significantly longer in the SPLC group. Length of hospitalization was shorter for patients operated on by SPLC (1.9 ± 0.9 vs 2.3 ± 1.2 days; P = .104). According to visual analogue scale evaluation, the pain profile was similar. Minor postoperative complications were present in 12.5% of the SPLC group and 2.5% in 4PLC group (P = .200). The total hospitalization costs associated with SPLC procedure were lower compared to standard 4PLC procedure. As regards the disposable operating room equipment costs, a statistically significant difference in favor of SPLC technique was found.

Conclusion: SPLC has shown relevant procedure and postoperative outcomes when compared to traditional 4PLC. The technique has proved to be promising even in cases of acute cholecystitis considered to date a relative contraindication. Further studies are needed to confirm its safety and feasibility in this setting. In contrast with the current evidence of increased costs for the single-port technique, a reduction of material and hospitalization costs was experienced in our study.

Keywords: Cholecystectomy; Health Care Costs; Laparoscopic; Treatment Outcome.

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Conflict of interest statement

Conflicts of Interest: All authors declare no conflict of interest regarding the publication of this article.

Figures

Figure 1.
Figure 1.
Intra-operative view. The four-channel Unimax singleport positioned at the umbilicus for a laparoscopic procedure.
See this image and copyright information in PMC

References

    1. Navarra G, Pozza E, Occhionorelli S. One-wound laparoscopic cholecystectomy. BrJ Surg. 1997;84:695–697. - PubMed
    1. Ponsky TA, Diluciano J, Chwals W, et al. Early experience with single-port laparoscopic surgery in children. J Laparoen-dosc Adv Surg Tech A. 2009;19:551–553. - PubMed
    1. Saber AA, El-Ghazaly TH, Dewoolkar AV. Single-incision laparoscopic bariatric surgery: a comprehensive review. Surg Obes Relat Dis. 2010;6:575–582. - PubMed
    1. Targarona EM, Balague C, Martinez C, et al. Single-port access: a feasible alternative to conventional laparoscopic splenectomy. Surg Innov. 2009;16:348–352. - PubMed
    1. Chow AG, Purkayastha S, Zacharakis E, Paraskeva P. Singleincision laparoscopic surgery for right hemicolectomy. Arch Surg. 2011;146:183–186. - PubMed

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