gms | German Medical Science

128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

Single port cholecystectomy obtaining a safe critical view with a totally reusable multichannel port device

Meeting Abstract

  • Katica Krajinovic - Universitätsklinikum Würzburg, Chirurgie I, Würzburg
  • Joachim Reibetanz - Universitätsklinikum Würzburg, Würzburg
  • Alexander Kerscher - Universitätsklinikum Würzburg, Würzburg
  • Christoph Thomas Germer - Universtitätsklinikum Würzburg, Klinik und Poliklinik für Allgemein- und Viszeralchirurgie, Würzburg

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch802

DOI: 10.3205/11dgch802, URN: urn:nbn:de:0183-11dgch8022

Published: May 20, 2011

© 2011 Krajinovic et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Introduction: Single-port access cholecystectomy (SPA) is an emerging concept in the field of minimally invasive surgery. In cholecystectomy, one of the gold standards for safety is preservation of the critical view of safety during hepatocystic triangle dissection. As single-port technique is more widely used it should not compromise this important operative principles of cholecystectomy. We report our experience in using a newly developed totally reusable multichannel port system for single-port cholecystectomy.

Materials and methods: Between August 2009 and August 2010, 59 patients with an average age of 45,3 years (range 19-84) underwent laparoscopic single port cholecystectomy for symptomatic cholelithiasis and acute cholecystitis using the totally reusable X-ConeTM multichannel single-port device in all cases.

Results: Of the 59 laparoscopic cholecystectomies, 52 were performed successfully with the totally reusable port device alone using one single incision in the umbilicus. In seven cases additional 3mm or 5mm instruments were placed into the right upper abdominal wall. No mortalities or major complications were noted. The exposure of the Calot triangle could be achieved very well by a defined placing of holding-instruments through the five working-channel single port device. The median operating time was 80 min and the median postoperative hospital stay was 1.5 days.

Conclusion: The results of this sery demonstrated the feasibility of single port cholecystectomy with the used totally reusable system. The operating times are reasonable and can be lessened with experience. The clear exposition of Calot`s triangle is the mainstay of this method and was achieved by allowing enough controlled strength for retraction and sufficient triangulation for adequate exposure of the surgical field. Beside cost-effectiveness was convincing.