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J Gastrointest Surg. 2010 Feb;14(2):404-7. doi: 10.1007/s11605-009-1079-0. Epub 2009 Nov 12.

Supra-pubic single incision cholecystectomy.

Author information

1
Department of Surgery, Center for the Future of Surgery, University of California, San Diego, CA 92108, USA. MonikaHagen@aol.com

Abstract

INTRODUCTION:

Surgery is moving towards less invasive and cosmetically superior approaches such as single incision laparoscopy (SIL). While trans-umbilical SIL is gaining popularity, incisions may lead to post-operative deformations of the umbilicus and the possibility of an increased rate of incisional hernias. Access within the pubic hairline allows preservation of the umbilicus and results in a scar which is concealed within the pubic hair.

METHODS:

Supra-pubic single incision cholecystectomy was performed in a 30-year-old patient with symptomatic gallstones. A 2.5-cm transverse incision was placed within the pubic hairline and a subcutaneous tunnel was formed. Three 5-mm ports were introduced into the tunnel and perforated the anterior rectus sheath superior to the skin incision. The surgical procedure was then undertaken with conventional laparoscopic instrumentation. The adjacent 5-mm incisions were merged for gallbladder removal. The entry site was closed under direct vision.

RESULTS:

The above procedure was technically feasible and without complication. Operative time was 45 min, and the patient was discharged 5 h post-operatively.

CONCLUSIONS:

Supra-pubic single incision laparoscopic cholecystectomy may offer a more cosmetically appealing result than standard umbilical access. The operation can be performed by surgeons skilled in single incision techniques with good result.

PMID:
19908104
PMCID:
PMC2809977
DOI:
10.1007/s11605-009-1079-0
[Indexed for MEDLINE]
Free PMC Article

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