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Clinical outcomes of single incision laparoscopic cholecystectomy in the anglophone Caribbean: a multi centre audit of regional hospitals.

Cawich SO, Albert M, Singh Y, Dan D, Mohanty S, Walrond M, Francis W, Simpson LK, Bonadie KO, Dapri G - Int J Biomed Sci (2014)

Bottom Line: Specialized access platforms were used in the first 35 cases and reusable instruments were passed directly across fascia in the latter 50 cases.The mean operative time was 62.9 ± 17.9 minutes.Ambulatory procedures were performed in 43/71 (60.6%) patients scheduled for elective operations.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of the West Indies, St. Augustine Campus, Trinidad & Tobago;

ABSTRACT

Introduction: There has been no report on Single-Incision Laparoscopic Surgery (SILS) cholecystectomy outcomes since it was first performed in the Anglophone Caribbean in 2009.

Methods: A retrospective audit evaluated the clinical outcomes of SILS cholecystectomies at regional hospitals in the 17 Anglophone Caribbean countries. Any cholecystectomy using a laparoscopic approach in which all instruments were passed through one access incision was considered a SILS cholecystectomy. The following data were collected: patient demographics, indications for operation, intraoperative details, surgeon details, surgical techniques, specialized equipment, conversions, morbidity and mortality. Descriptive statistics were generated using SPSS 12.0.

Results: There were 85 SILS cholecystectomies in women at a mean age of 37.4 ± 8.5 years with a mean BMI of 30.9 ± 2.8. There were 59 elective and 26 emergent cases. Specialized access platforms were used in the first 35 cases and reusable instruments were passed directly across fascia in the latter 50 cases. The mean operative time was 62.9 ± 17.9 minutes. There was no mortality, 2 conversions to multi-trocar laparoscopy and 5 minor complications. Ambulatory procedures were performed in 43/71 (60.6%) patients scheduled for elective operations.

Conclusion: In the Caribbean setting, SILS cholecystectomy is a feasible and safe alternative to conventional multi-trocar laparoscopic cholecystectomy for gallbladder disease.

No MeSH data available.


Related in: MedlinePlus

SILS technique using a single 11 mm trocar (visual) with curved reusable instruments passed directly across the fascia without access ports.
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Figure 1: SILS technique using a single 11 mm trocar (visual) with curved reusable instruments passed directly across the fascia without access ports.

Mentions: In the latter 50 cases specialized access ports were abandoned in favour of a previously described technique (18) using a single reusable 11 mm standard trocar with 5 mm DAPRI curved reusable instruments (Karl Storz Endoskope, Tuttlingen, Germany) passed directly across the fascia (Fig. 1). Regardless of the access platform utilized, similar techniques were used for intra-corporal dissection and identification of biliary structures. No operative cholangiograms or additional procedures were performed in this series.


Clinical outcomes of single incision laparoscopic cholecystectomy in the anglophone Caribbean: a multi centre audit of regional hospitals.

Cawich SO, Albert M, Singh Y, Dan D, Mohanty S, Walrond M, Francis W, Simpson LK, Bonadie KO, Dapri G - Int J Biomed Sci (2014)

SILS technique using a single 11 mm trocar (visual) with curved reusable instruments passed directly across the fascia without access ports.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199470&req=5

Figure 1: SILS technique using a single 11 mm trocar (visual) with curved reusable instruments passed directly across the fascia without access ports.
Mentions: In the latter 50 cases specialized access ports were abandoned in favour of a previously described technique (18) using a single reusable 11 mm standard trocar with 5 mm DAPRI curved reusable instruments (Karl Storz Endoskope, Tuttlingen, Germany) passed directly across the fascia (Fig. 1). Regardless of the access platform utilized, similar techniques were used for intra-corporal dissection and identification of biliary structures. No operative cholangiograms or additional procedures were performed in this series.

Bottom Line: Specialized access platforms were used in the first 35 cases and reusable instruments were passed directly across fascia in the latter 50 cases.The mean operative time was 62.9 ± 17.9 minutes.Ambulatory procedures were performed in 43/71 (60.6%) patients scheduled for elective operations.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of the West Indies, St. Augustine Campus, Trinidad & Tobago;

ABSTRACT

Introduction: There has been no report on Single-Incision Laparoscopic Surgery (SILS) cholecystectomy outcomes since it was first performed in the Anglophone Caribbean in 2009.

Methods: A retrospective audit evaluated the clinical outcomes of SILS cholecystectomies at regional hospitals in the 17 Anglophone Caribbean countries. Any cholecystectomy using a laparoscopic approach in which all instruments were passed through one access incision was considered a SILS cholecystectomy. The following data were collected: patient demographics, indications for operation, intraoperative details, surgeon details, surgical techniques, specialized equipment, conversions, morbidity and mortality. Descriptive statistics were generated using SPSS 12.0.

Results: There were 85 SILS cholecystectomies in women at a mean age of 37.4 ± 8.5 years with a mean BMI of 30.9 ± 2.8. There were 59 elective and 26 emergent cases. Specialized access platforms were used in the first 35 cases and reusable instruments were passed directly across fascia in the latter 50 cases. The mean operative time was 62.9 ± 17.9 minutes. There was no mortality, 2 conversions to multi-trocar laparoscopy and 5 minor complications. Ambulatory procedures were performed in 43/71 (60.6%) patients scheduled for elective operations.

Conclusion: In the Caribbean setting, SILS cholecystectomy is a feasible and safe alternative to conventional multi-trocar laparoscopic cholecystectomy for gallbladder disease.

No MeSH data available.


Related in: MedlinePlus