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129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

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Single Incision Laparoscopic Cholecystectomy as the First Choice Approach in 300 Patients

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  • Jan Schirnhofer - Kh Barmherzige Brüder Salzburg, allg. Chirurgie, Salzburg
  • Katharina Pimpl - Krankenhaus der Barmherzigen Brüder, Allgemeinchirurgie, Salzburg
  • Christof Mittermair - Kh Barmherzige Brüder Salzburg, allg. Chirurgie, Salzburg
  • Christian Obrist - Kh Barmherzige Brüder Salzburg, allg. Chirurgie, Salzburg
  • Matthias Biebl - Kh Barmherzige Brüder Salzburg, allg. Chirurgie, Salzburg
  • Helmut Weiss - Kh Barmherzige Brüder Salzburg, allg. Chirurgie, Salzburg

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch028

doi: 10.3205/12dgch028, urn:nbn:de:0183-12dgch0282

Published: April 23, 2012

© 2012 Schirnhofer 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: During the last years single incision laparoscopy (SIL) has become popular for cholecystectomy (CHE). After having passed the learning curve of 15 SIL-cholecystectomies in selected patients we offered this approach to all patients.

Materials and methods: From 08-2008 to 01-2011 we performed a number of 300 SIL-CHE without selection in all patients who were eligible for laparoscopy (mean age 56 years, mean BMI 26kg/m2). Different trocars were utilized as available. Different armamentarium was used. Additional trocars were inserted on demand. Perioperative parameters (operation time, complications, pain) were assessed. Data were prospectively collected in a data-base and analyzed.

Results: 87% of all procedures could be completed without adding an extraumbilical trocar. In one patient conversion to open CHE was indicated for safety reasons. Operating time yielded in mean 52 minutes. The umbilical reconstruction was optimal in 94%. Postoperative complications included two major complications (duodenal injury and bile duct laceration).

Conclusion: Initial expertise confirms the value of the novel transumbilical laparoscopic approach for cholecystectomy even at first choice. Surgical safety and outcomes has to remain uncompromised by adding one or more additional trocars.