Single incision laparoscopic cholecystectomy-two hands technique

Abstract

          Background Laparoscopic cholecystectomy has been recognized as the gold standard procedure for gallbladder surgery but they have 3-4 wound. Single-incision laparoscopic (SILS) cholecystectomy with two hands technique is a step forward for less invasive surgical procedures.

          Methods Through a 2.5-cm subumbilical incision, SILS™ Port  was applied. A 12-mm trocar was introduced left side for 10-mm 0 degrees optic. Second and third 5 mm trocars were introduced at the right upper and lower position.The Left hand control camera while the Right one use dissect,cautery or clip tools.Reticulator grasper was controlled by assistant. The hilum was dissected and the cystic duct and artery were clipped and divided. Gallbladder with SILS™ Port was removed from the abdomen. Patient demographic data, operative time, length of stay, surgical pathology, and complications were recorded.

          Results Fifty-four of 56 patients successfully underwent single-port cholecystectomies. Two patients required conversion to open cholecystectomy because of chronic cholecystitis and big body(bmi =36.62). The average age was 50years and average BMI was 22.06 kg/m2. Mean operative time was 36 min. Length of stay was 3 days. No complications. Operative times decreased significantly after the first 10 patients and then remained flat..

          Conclusion  Single incision laparoscopic cholecystectomy by two hands technique is feasible, safe, and effective. No need to suture sustend gallbalder. Only reticulator graper and SILS™ Port is used.By using benefit of sword effect with other standard equipment is an advantage of this technique