Single incision versus conventional four ports laparoscopic cholecystectomy: a Prospective comparative study

Background Laparoscopic cholecystectomy (LC) is now considered the gold standard for the treatment of symptomatic gallstone disease. Traditionally, it was performed with a four-port approach. Recently, attempts have been done to improve the established technique of LC aiming to minimize the invasiveness of this procedure by reducing the number and size of the surgical ports and instruments. Navarra and colleagues described the first single-incision laparoscopic surgery in 1997. It was performed using multiple ports through a single incision with the removal of the gallbladder through a single periumbilical skin incision. Patients and methods This prospective study was carried out on 40 patients with uncomplicated chronic calcular cholecystitis categorized into two equal groups. Group A patients underwent single-incision LC, whereas conventional LC was done in group B patients in the Gastrointestinal and Laparoscopic Surgery Unit, General Surgery Department, Tanta University Hospitals, during the study period (12 months, from November 2019 to November 2020 on 40 patients). Results There was no statistically significant difference between both groups regarding patient characteristics, and preoperative medical or surgical history. The operative time was significantly longer in group A patients with a mean 85.8 +/- 25.3 min compared with group B in which the mean was 71 +/- 2.6 min. The difference between both groups regarding postoperative pain, analgesia intake, and hospital stay was insignificant. Cosmetic satisfaction was significantly better in group A compared with group B. Conclusion Single-incision laparoscopic cholecystectomy is a safe, feasible but challenging procedure that needs experienced hands in handling the instruments in lack of triangulation.