One for All: Single Incision Laparoscopic Cholecystectomy vs Conventional Laparoscopic Cholecystectomy
EAES Academy. Bhandarwar A. 07/05/22; 363046; P090
Ajay Bhandarwar
Contributions
Contributions
Abstract
Background:
Single Incision Laparoscopic Surgery, is an alternative to conventional multi-port laparoscopic surgeries. Many studies have shown that reducing the number of ports and the total length of the incisions significantly reduces post-operative pain, earlier return of intestinal function, reduced use of analgesics, earlier return to work, improved final aesthetic results and, ultimately, greater patient satisfaction. In this study we aim to compare the single incision approach vs the conventional approach for laparoscopic cholecystectomy.
Materials: We conducted a prospective cohort study at our hospital, comparing 30 patients each undergoing conventional laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy. Quality of Life (QoL) scoring was done using SF-36 questionnaire preoperatively, and then reassessed at 3 months post operatively. The pain experienced by the patient was graded subjectively by the patient on a Visual analogue Scale of 1 to 10 and recorded every 12 hourly for the first 24 hours post-operatively. Analgesics were given if VAS score was >5. The final cosmesis, as perceived by the patient using the Scar Scale on a scale of 3 to 15, was noted 3 months post operatively, with 3 being the best result and 15 being the worst recorded. Other data included demographics, intra-operative and post-operative course, duration of hospital stay, hospital cost and expenditure.
Results:
We found out that single incision laparoscopic cholecystectomy is associated with longer operative time (65 mins vs 55 mins), a longer hospital stay (5 days vs 2.5 days) and higher hospital expenditure. Intraoperative complications like bleeding and inadvertent gall bladder perforation were more in the single incision group (10% vs 3.3%), and on follow up, 2 patients from the single incision group had surgical site infection and port site herniation compared to none from the conventional laparoscopy group. The patients reported better cosmetic outcome in the single incision laparoscopic cholecystectomy group.
Conclusion:
Single incision laparoscopic cholecystectomy outscored conventional laparoscopic cholecystectomy with regards to final cosmesis and quality of life parameters, however, it comes with higher economic burden, longer operative times, longer learning curve and untoward intra-operative and post-operative events.
Single Incision Laparoscopic Surgery, is an alternative to conventional multi-port laparoscopic surgeries. Many studies have shown that reducing the number of ports and the total length of the incisions significantly reduces post-operative pain, earlier return of intestinal function, reduced use of analgesics, earlier return to work, improved final aesthetic results and, ultimately, greater patient satisfaction. In this study we aim to compare the single incision approach vs the conventional approach for laparoscopic cholecystectomy.
Materials: We conducted a prospective cohort study at our hospital, comparing 30 patients each undergoing conventional laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy. Quality of Life (QoL) scoring was done using SF-36 questionnaire preoperatively, and then reassessed at 3 months post operatively. The pain experienced by the patient was graded subjectively by the patient on a Visual analogue Scale of 1 to 10 and recorded every 12 hourly for the first 24 hours post-operatively. Analgesics were given if VAS score was >5. The final cosmesis, as perceived by the patient using the Scar Scale on a scale of 3 to 15, was noted 3 months post operatively, with 3 being the best result and 15 being the worst recorded. Other data included demographics, intra-operative and post-operative course, duration of hospital stay, hospital cost and expenditure.
Results:
We found out that single incision laparoscopic cholecystectomy is associated with longer operative time (65 mins vs 55 mins), a longer hospital stay (5 days vs 2.5 days) and higher hospital expenditure. Intraoperative complications like bleeding and inadvertent gall bladder perforation were more in the single incision group (10% vs 3.3%), and on follow up, 2 patients from the single incision group had surgical site infection and port site herniation compared to none from the conventional laparoscopy group. The patients reported better cosmetic outcome in the single incision laparoscopic cholecystectomy group.
Conclusion:
Single incision laparoscopic cholecystectomy outscored conventional laparoscopic cholecystectomy with regards to final cosmesis and quality of life parameters, however, it comes with higher economic burden, longer operative times, longer learning curve and untoward intra-operative and post-operative events.
Background:
Single Incision Laparoscopic Surgery, is an alternative to conventional multi-port laparoscopic surgeries. Many studies have shown that reducing the number of ports and the total length of the incisions significantly reduces post-operative pain, earlier return of intestinal function, reduced use of analgesics, earlier return to work, improved final aesthetic results and, ultimately, greater patient satisfaction. In this study we aim to compare the single incision approach vs the conventional approach for laparoscopic cholecystectomy.
Materials: We conducted a prospective cohort study at our hospital, comparing 30 patients each undergoing conventional laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy. Quality of Life (QoL) scoring was done using SF-36 questionnaire preoperatively, and then reassessed at 3 months post operatively. The pain experienced by the patient was graded subjectively by the patient on a Visual analogue Scale of 1 to 10 and recorded every 12 hourly for the first 24 hours post-operatively. Analgesics were given if VAS score was >5. The final cosmesis, as perceived by the patient using the Scar Scale on a scale of 3 to 15, was noted 3 months post operatively, with 3 being the best result and 15 being the worst recorded. Other data included demographics, intra-operative and post-operative course, duration of hospital stay, hospital cost and expenditure.
Results:
We found out that single incision laparoscopic cholecystectomy is associated with longer operative time (65 mins vs 55 mins), a longer hospital stay (5 days vs 2.5 days) and higher hospital expenditure. Intraoperative complications like bleeding and inadvertent gall bladder perforation were more in the single incision group (10% vs 3.3%), and on follow up, 2 patients from the single incision group had surgical site infection and port site herniation compared to none from the conventional laparoscopy group. The patients reported better cosmetic outcome in the single incision laparoscopic cholecystectomy group.
Conclusion:
Single incision laparoscopic cholecystectomy outscored conventional laparoscopic cholecystectomy with regards to final cosmesis and quality of life parameters, however, it comes with higher economic burden, longer operative times, longer learning curve and untoward intra-operative and post-operative events.
Single Incision Laparoscopic Surgery, is an alternative to conventional multi-port laparoscopic surgeries. Many studies have shown that reducing the number of ports and the total length of the incisions significantly reduces post-operative pain, earlier return of intestinal function, reduced use of analgesics, earlier return to work, improved final aesthetic results and, ultimately, greater patient satisfaction. In this study we aim to compare the single incision approach vs the conventional approach for laparoscopic cholecystectomy.
Materials: We conducted a prospective cohort study at our hospital, comparing 30 patients each undergoing conventional laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy. Quality of Life (QoL) scoring was done using SF-36 questionnaire preoperatively, and then reassessed at 3 months post operatively. The pain experienced by the patient was graded subjectively by the patient on a Visual analogue Scale of 1 to 10 and recorded every 12 hourly for the first 24 hours post-operatively. Analgesics were given if VAS score was >5. The final cosmesis, as perceived by the patient using the Scar Scale on a scale of 3 to 15, was noted 3 months post operatively, with 3 being the best result and 15 being the worst recorded. Other data included demographics, intra-operative and post-operative course, duration of hospital stay, hospital cost and expenditure.
Results:
We found out that single incision laparoscopic cholecystectomy is associated with longer operative time (65 mins vs 55 mins), a longer hospital stay (5 days vs 2.5 days) and higher hospital expenditure. Intraoperative complications like bleeding and inadvertent gall bladder perforation were more in the single incision group (10% vs 3.3%), and on follow up, 2 patients from the single incision group had surgical site infection and port site herniation compared to none from the conventional laparoscopy group. The patients reported better cosmetic outcome in the single incision laparoscopic cholecystectomy group.
Conclusion:
Single incision laparoscopic cholecystectomy outscored conventional laparoscopic cholecystectomy with regards to final cosmesis and quality of life parameters, however, it comes with higher economic burden, longer operative times, longer learning curve and untoward intra-operative and post-operative events.
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