The real-world application of single incision laparoscopic cholecystectomy

Objectives: Most previous studies that have investigated single incision laparoscopic cholecystectomy (SILC) are case series with limited sample sizes. We have reviewed the outcome of 500 consecutive cases of SILC performed by a single surgeon at our center. Materials and Methods: From April 2009 to October 2012, a single surgeon performed 1250 laparoscopic cholecystectomies for various gallbladder (GB) diseases. SILC was chosen as the surgical modality unless there was evidence of acute cholecystitis or GB empyema, the patient had a prior history of upper abdominal surgery, endoscopic sphincterotomy, or had comorbidities with an ASA score of III or higher. The clinicopathologic features and perioperative data of patients were retrospectively reviewed. Results: The mean age and BMI of included patients were 42.7 years and 23.6kg/m², respectively. The mean operating time was 52min. Patients stayed in the hospital for an average of 1.3 days postoperatively. In 55 patients, an additional 2mm trocar was inserted for retraction of the GB. One patient was converted to an open cholecystectomy because of Mirizzi syndrome. There were no observed complications including incisional hernias in this patient population. Conclusions: SILC is a safe, effective procedure for cholecystectomy that may be considered the main surgical strategy in select patients.