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Year : 2019  |  Volume : 52  |  Issue : 4  |  Page : 133-138

Mini-single-incision laparoscopic cholecystectomy: Pursuing the least invasive procedure

Department of Surgery, Division of General Surgery, Hsinchu MacKay Memorial Hospital, Hsin-Chu; Department of Health Food, College of Health, Chung Chou University of Science and Technology, Changhua, Taiwan

Correspondence Address:
Dr. Shu-Hung Chuang
Department of Surgery, Division of General Surgery, Hsinchu MacKay Memorial Hospital, No. 690, Sec. 2, Guangfu Road, Hsin-Chu 30071
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_130_18

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Background: Both mini-laparoscopic surgery and single-incision laparoscopic surgery are feasible and safe alternatives to conventional multi-incision laparoscopic surgery. Materials and Methods: Fifty-one conventional single-incision laparoscopic cholecystectomies (CSILCs) and 34 mini-single-incision laparoscopic cholecystectomies (MSILCs) were performed by a single surgeon for uncomplicated diseases. Compared with a 2-cm paraumbilical incision in CSILC, the incision in MSILC was 1.2 cm in length. Results: In the CSILC period, all the procedures were performed successfully except one (2.2%). In the MSILC period, 6 (15%) CSILCs and 34 (85%) MSILCs were scheduled. All the former procedures were successful, whereas three MSILCs were converted to CSILCs. Fewer patients needed more than two pethidine doses, and the accumulated dosage was lower in the MSILC period compared with the CSILC period (2 [5.0%] vs. 11 [24.4%] and 0.595 ± 0.505 mg/kg vs. 0.936 ± 0.912 mg/kg, P < 0.05). The complication rates were 2.2% and 2.5% in the CSILC and MSILC periods, respectively (Clavien–Dindo Grade I). Conclusion: MSILC can be performed safely for uncomplicated diseases. Compared with CSILC, MSILC has advantages of reduced postoperative pain and faster recovery but potentially increases operative time. Careful patient selection with a low threshold of conversion is obligatory.

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