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Review of 100 cases of single port laparoscopic cholecystectomy.

Koo EJ, Youn SH, Baek YH, Roh YH, Choi HJ, Kim YH, Jung GJ - J Korean Surg Soc (2012)

Bottom Line: SPLC is a safe and practicable technique.The operating time is moderate and can be reduced with the surgeon's experience.SPLC is occupying a greater domain of conventional laparoscopic cholecystectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Purpose: Single port laparoscopic cholecystectomy (SPLC) is a new advanced technique in laparoscopic surgery. Many laparoscopic surgeons seek to gain skill in this new technique. However, little data has been accumulated and published formally yet. This article reports the achievement of 100 cases of SPLC with the hopes it will encourage laparoscopic surgery centers in the early adoption of SPLC.

Methods: A retrospective review of 100 prospectively selected cases of SPLC was carried out. All patients had received elective SPLC by a single surgeon in our center from May 2009 to December 2010. Our review suggests patients' character, perioperative data and postoperative outcomes.

Results: Forty-two men and 58 women with an average age of 45.8 years had received SPLC. Their mean body mass index (BMI) was 23.85 kg/m(2). The mean operating time took 76.75 minutes. However, operating time was decreased according to the increase of experience of SPLC cases. Twenty-one cases were converted to multi-port surgery. BMI, age, previous low abdominal surgical history did not seem to affect conversion to multi-port surgery. No cases were converted to open surgery. Mean duration of hospital stay was 2.18 days. Six patients had experienced complications from which they had recovered after conservative treatment.

Conclusion: SPLC is a safe and practicable technique. The operating time is moderate and can be reduced with the surgeon's experience. At first, strict criteria was indicated for SPLC, however, with surgical experience, the criteria and area of SPLC can be broadened. SPLC is occupying a greater domain of conventional laparoscopic cholecystectomy.

No MeSH data available.


Related in: MedlinePlus

Operating time and learning curve. The learning curve for single port laparoscopic cholecystectomy should be around 30 cases. The time decreasing slope was stiff for the early 30 cases. After that the slope became flat, because more difficult cases were enrolled.
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Figure 1: Operating time and learning curve. The learning curve for single port laparoscopic cholecystectomy should be around 30 cases. The time decreasing slope was stiff for the early 30 cases. After that the slope became flat, because more difficult cases were enrolled.

Mentions: From May 2009 to December 2010, 100 cases of SPLC were performed by a single surgeon. Table 1 shows us patient characteristics including age, gender, BMI, previous history of abdominal surgery, diagnostic tools, patients' symptom and diagnoses. Forty-two men and 58 women aged an average of 45.8 years (range, 27 to 68 years) received SPLC. Their mean BMI was 23.85 kg/m2 (range, 18.4 to 33.7 kg/m2). The BMI of 22 patients were over than 25 kg/m2. Mean operating time took 76.75 minutes (range, 45 to 125 minutes). However, operating time decreased according to the increase of experience of single port surgery cases. Fig. 1 explains operating time saved according to the surgeon's experiences [17]. Twenty-one patients had had a history of previous surgery. Nine underwent appendectomy, 13 had obstetric and gynecologic surgery, and 2 had urology surgery. Sixty-seven patients had no symptom, 27 patients had abdominal pain and 6 had gastric discomfort. Forty-nine patients were diagnosed with GB stone, 32 of them were symptomatic cholecystitis with GB stone. Fifty patients were diagnosed with GB polyp, and 1 was GB empyema. Twenty-four of the 50 patients diagnosed with GB polyp, were pathologically diagnosed with cholesterol polyp and the other 26 were tubular adenoma. CT and US were used for the diagnoses. Eighteen cases had intra-operative bile leakage because GB were injured when dissected from the liver bed; 10 cases were cholecystitis and 8 were GB polyp. No postoperative bile leakage occurred. Eighty-four patients were discharged two days after operation.


Review of 100 cases of single port laparoscopic cholecystectomy.

Koo EJ, Youn SH, Baek YH, Roh YH, Choi HJ, Kim YH, Jung GJ - J Korean Surg Soc (2012)

Operating time and learning curve. The learning curve for single port laparoscopic cholecystectomy should be around 30 cases. The time decreasing slope was stiff for the early 30 cases. After that the slope became flat, because more difficult cases were enrolled.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3294112&req=5

Figure 1: Operating time and learning curve. The learning curve for single port laparoscopic cholecystectomy should be around 30 cases. The time decreasing slope was stiff for the early 30 cases. After that the slope became flat, because more difficult cases were enrolled.
Mentions: From May 2009 to December 2010, 100 cases of SPLC were performed by a single surgeon. Table 1 shows us patient characteristics including age, gender, BMI, previous history of abdominal surgery, diagnostic tools, patients' symptom and diagnoses. Forty-two men and 58 women aged an average of 45.8 years (range, 27 to 68 years) received SPLC. Their mean BMI was 23.85 kg/m2 (range, 18.4 to 33.7 kg/m2). The BMI of 22 patients were over than 25 kg/m2. Mean operating time took 76.75 minutes (range, 45 to 125 minutes). However, operating time decreased according to the increase of experience of single port surgery cases. Fig. 1 explains operating time saved according to the surgeon's experiences [17]. Twenty-one patients had had a history of previous surgery. Nine underwent appendectomy, 13 had obstetric and gynecologic surgery, and 2 had urology surgery. Sixty-seven patients had no symptom, 27 patients had abdominal pain and 6 had gastric discomfort. Forty-nine patients were diagnosed with GB stone, 32 of them were symptomatic cholecystitis with GB stone. Fifty patients were diagnosed with GB polyp, and 1 was GB empyema. Twenty-four of the 50 patients diagnosed with GB polyp, were pathologically diagnosed with cholesterol polyp and the other 26 were tubular adenoma. CT and US were used for the diagnoses. Eighteen cases had intra-operative bile leakage because GB were injured when dissected from the liver bed; 10 cases were cholecystitis and 8 were GB polyp. No postoperative bile leakage occurred. Eighty-four patients were discharged two days after operation.

Bottom Line: SPLC is a safe and practicable technique.The operating time is moderate and can be reduced with the surgeon's experience.SPLC is occupying a greater domain of conventional laparoscopic cholecystectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Purpose: Single port laparoscopic cholecystectomy (SPLC) is a new advanced technique in laparoscopic surgery. Many laparoscopic surgeons seek to gain skill in this new technique. However, little data has been accumulated and published formally yet. This article reports the achievement of 100 cases of SPLC with the hopes it will encourage laparoscopic surgery centers in the early adoption of SPLC.

Methods: A retrospective review of 100 prospectively selected cases of SPLC was carried out. All patients had received elective SPLC by a single surgeon in our center from May 2009 to December 2010. Our review suggests patients' character, perioperative data and postoperative outcomes.

Results: Forty-two men and 58 women with an average age of 45.8 years had received SPLC. Their mean body mass index (BMI) was 23.85 kg/m(2). The mean operating time took 76.75 minutes. However, operating time was decreased according to the increase of experience of SPLC cases. Twenty-one cases were converted to multi-port surgery. BMI, age, previous low abdominal surgical history did not seem to affect conversion to multi-port surgery. No cases were converted to open surgery. Mean duration of hospital stay was 2.18 days. Six patients had experienced complications from which they had recovered after conservative treatment.

Conclusion: SPLC is a safe and practicable technique. The operating time is moderate and can be reduced with the surgeon's experience. At first, strict criteria was indicated for SPLC, however, with surgical experience, the criteria and area of SPLC can be broadened. SPLC is occupying a greater domain of conventional laparoscopic cholecystectomy.

No MeSH data available.


Related in: MedlinePlus