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J Gastrointest Surg. 2010 Mar;14(3):506-10. doi: 10.1007/s11605-009-1116-z. Epub 2009 Dec 5.

Single-incision laparoscopic cholecystectomy: a surgeon's initial experience with 56 consecutive cases and a review of the literature.

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Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.



We describe the results of a single surgeon's initial experience with single-incision laparoscopic cholecystectomy through his first 56 cases and provide a brief literature review on the development of this technique.


Through a 2-cm vertical transumbilical incision, three 5-mm ports were placed using the Veress technique. One extracorporeal suture was utilized to provide cephalad retraction of the fundus, and a roticulating instrument grasping the infundibulum provided lateral retraction. The hilum was dissected, and the cystic duct and artery were clipped and divided. One 5-mm port was upgraded to a 10-mm port to allow the introduction of a retrieval bag, and the gallbladder was removed from the abdomen.


Of 56 patients, 54 successfully underwent a single-incision laparoscopic cholecystectomy. Two patients required conversion to either a conventional laparoscopic cholecystectomy or open cholecystectomy. The average age was 41 years (18-77) and the average BMI, 30.2 kg/m(2) (18.5-44.6). Mean operative time was 80 min (41-186). Length of stay was 0.3 days (0-2). The complication rate was 3/56 (5.4%).


Our results suggest that single-incision laparoscopic cholecystectomy is a safe and effective alternative to four-port laparoscopic cholecystectomy that provides surgeons with an alternative minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus.

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