Single-incision laparoscopic cholecystectomy: The first Malaysian experience

Abstract

Introduction: Single-incision laparoscopic cholecystectomy (SILC) is an evolving concept in minimally invasive surgery. It utilizes the concept of inline viewing and a single incision that accommodates all of the working instruments. Here, we describe a single surgeon's initial experiences of using this technique in a tertiary hospital. Methods: Between January and September 2010, 21 patients underwent SILC for symptomatic cholelithiasis. The umbilicus was the point of access into abdomen for all patients using a 2.0–2.5-cm incision. The surgeries were performed using the Covidien SILS port with a 30° angled scope and two 5-mm conventional laparoscopic instruments. Results: Nineteen patients successfully underwent surgery (8 males and 11 females; mean age: 43 years). The mean body mass index was 25.9 kg/m2 (range: 19.0–38.2 kg/m2). The mean operative time was 89 minutes (range: 55–135 minutes). Minimal blood loss was noted in each patient. The mean length of the postoperative stay was 1.1 days (range: 1–3 days). No complications or mortalities were associated with the technique. The visual analogue score for pain at the 1-day and 6-week follow-up examinations was 2 (range: 1–7) and 0.6 (range: 0–3), respectively. At 6 weeks, the mean satisfaction score for the resultant scar was 8.8 (range: 4–10) and the mean overall satisfaction score was 9.2 (range: 7–10). The mean time until returning to work or normal activities was 8.8 days (range: 1–21 days). Conclusion: SILC is feasible and demonstrates a good clinical outcome.

Keywords

• cholecystectomy
• single-incision laparoscopic surgery
• single-incision laparoscopic cholecystectomy
• SILS
• transumbilical access