Single-incision laparoscopic cholecystectomy: the first Malaysian experience.

Siow, Sze Li; Khor, Tze Wei; Chea, Chan Hooi; Nik Azim, Nik Abdullah

INTRODUCTION Single-incision laparoscopic cholecystectomy (SILC) is an evolving concept in minimally invasive surgery. It utilizes the concept of inline viewing and a single incision that accommodates all of the working instruments. Here, we describe a single surgeon's initial experiences of using this technique in a tertiary hospital. METHODS Between January and September 2010, 21 patients underwent SILC for symptomatic cholelithiasis. The umbilicus was the point of access into abdomen for all patients using a 2.0-2.5-cm incision. The surgeries were performed using the Covidien SILS port with a 30° angled scope and two 5-mm conventional laparoscopic instruments. RESULTS Nineteen patients successfully underwent surgery (8 males and 11 females; mean age: 43 years). The mean body mass index was 25.9 kg/m(2) (range: 19.0-38.2 kg/m(2)). The mean operative time was 89 minutes (range: 55-135 minutes). Minimal blood loss was noted in each patient. The mean length of the postoperative stay was 1.1 days (range: 1-3 days). No complications or mortalities were associated with the technique. The visual analogue score for pain at the 1-day and 6-week follow-up examinations was 2 (range: 1-7) and 0.6 (range: 0-3), respectively. At 6 weeks, the mean satisfaction score for the resultant scar was 8.8 (range: 4-10) and the mean overall satisfaction score was 9.2 (range: 7-10). The mean time until returning to work or normal activities was 8.8 days (range: 1-21 days). CONCLUSION SILC is feasible and demonstrates a good clinical outcome.