Single incision laparoscopic cholecystectomy: for what benefit?

Abstract Background A single‐incision laparoscopic cholecystectomy (SILC) was developed to improve outcomes as compared with the four‐port classic laparoscopic cholecystectomy (CLC). Any potential benefits associated with a SILC have been suggested by previous studies reporting few patients with different surgical techniques. The aim of this study was to describe the experience with a standardized SILC as compared with CLC. Methods From June 2010 to January 2012, 40 patients underwent a SILC [median age: 47.5 years (25–92)] and operative and peri‐operative data were prospectively collected. Over the same period, 37 patients underwent a CLC. A 10‐point visual analogue scale (VAS) was used for qualitative data. The costs of SILC and CLC were also compared. Results For those patients undergoing a SILC the median operating time was 70 min (24–110). There were no conversions. An additional trocar was necessary in 16 patients. Four patients developed post‐operative complications. The median immediate post‐operative pain score was 5 (0–10). The median quality of life and cosmetic satisfaction at the initial post‐operative visit were 10 (6–10) and 10 (5–10), respectively (VAS). Although the surgical results of both groups were similar, post‐operative complications were exclusively reported in the SILC group (two incisional hernias). Conclusion Standardization of SILC is possible but associated with an important rate of additional trocar placement and a disturbing rate of incisional hernias.