Single-Incision Laparoscopic Cholecystectomy Using a Flexible Endoscope | Gastrointestinal Surgery | JAMA Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Lichten  JBReid  JJZahalsky  MPFriedman  RL Laparoscopic cholecystectomy in the new millennium.  Surg Endosc 2001;15 (8) 867- 872PubMedGoogle Scholar
Sarli  LPietra  NSansebastiano  G  et al.  Reduced postoperative morbidity after elective laparoscopic cholecystectomy: stratified matched case-control study.  World J Surg 1997;21 (8) 872- 878, discussion 879PubMedGoogle Scholar
Kum  CKWong  CWGoh  PMTi  TK Comparative study of pain level and analgesic requirement after laparoscopic and open cholecystectomy.  Surg Laparosc Endosc 1994;4 (2) 139- 141PubMedGoogle Scholar
Boni  LBenevento  ARovera  F  et al.  Infective complications in laparoscopic surgery.  Surg Infect (Larchmt) 2006;7 ((suppl 2)) S109- S111PubMedGoogle Scholar
den Hoed  PTBoelhouwer  RUVeen  HFHop  WCBruining  HA Infections and bacteriological data after laparoscopic and open gallbladder surgery.  J Hosp Infect 1998;39 (1) 27- 37PubMedGoogle Scholar
Sanz-López  RMartínez-Ramos  CNúñez-Peña  JRRuiz de Gopegui  MPastor-Sirera  LTamames-Escobar  S Incisional hernias after laparoscopic vs open cholecystectomy.  Surg Endosc 1999;13 (9) 922- 924PubMedGoogle Scholar
Zacks  SLSandler  RSRutledge  RBrown  RS  Jr A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy.  Am J Gastroenterol 2002;97 (2) 334- 340PubMedGoogle Scholar
Ress  AMSarr  MGNagorney  DMFarnell  MBDonohue  JH McIlrath  DC Spectrum and management of major complications of laparoscopic cholecystectomy.  Am J Surg 1993;165 (6) 655- 662PubMedGoogle Scholar
Roviaro  GCMaciocco  MRebuffat  C  et al.  Complications following cholecystectomy.  J R Coll Surg Edinb 1997;42 (5) 324- 328PubMedGoogle Scholar
Massoumi  HKiyici  NHertan  H Bile leak after laparoscopic cholecystectomy.  J Clin Gastroenterol 2007;41 (3) 301- 305PubMedGoogle Scholar
Saville  LEWoods  MS Laparoscopy and major retroperitoneal vascular injuries (MRVI).  Surg Endosc 1995;9 (10) 1096- 1100PubMedGoogle Scholar
Geraci  GSciume  CPisello  FLi Volsi  FFacella  TModica  G Trocar-related abdominal wall bleeding in 200 patients after laparoscopic cholecystectomy: personal experience.  World J Gastroenterol 2006;12 (44) 7165- 7167PubMedGoogle Scholar
Binenbaum  SJGoldfarb  MA Inadvertent enterotomy in minimally invasive abdominal surgery.  JSLS 2006;10 (3) 336- 340PubMedGoogle Scholar
Corson  SLChandler  JGWay  LW Survey of laparoscopic entry injuries provoking litigation.  J Am Assoc Gynecol Laparosc 2001;8 (3) 341- 347PubMedGoogle Scholar
Schafer  MLauper  MKrahenbuhl  L Trocar and Veress needle injuries during laparoscopy [published online ahead of print December 12, 2000].  Surg Endosc 2001;15 (3) 275- 280Google Scholar
Orlando  RPalatini  PLirussi  F Needle and Trocar injuries in diagnostic laparoscopy under local anesthesia: what is the true incidence of these complications?  J Laparoendosc Adv Surg Tech A 2003;13 (3) 181- 184PubMedGoogle Scholar
Hashizume  MSugimachi  K Needle and trocar injury during laparoscopic surgery in Japan.  Surg Endosc 1997;11 (12) 1198- 1201PubMedGoogle Scholar
Bhoyrul  SVierra  MANezhat  CRKrummel  TMWay  LW Trocar injuries in laparoscopic surgery.  J Am Coll Surg 2001;192 (6) 677- 683PubMedGoogle Scholar
Navarra  GPozza  EOcchionorelli  SCarcoforo  PDonini  I One-wound laparoscopic cholecystectomy.  Br J Surg 1997;84 (5) 695PubMedGoogle Scholar
Piskun  GRajpal  S Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus.  J Laparoendosc Adv Surg Tech A 1999;9 (4) 361- 364PubMedGoogle Scholar
Cuesta  MABerends  FVeenhof  AA The “invisible cholecystectomy”: a transumbilical laparoscopic operation without a scar [published online October 18, 2007].  Surg Endosc 10.1007/s00464-007-9588-yGoogle Scholar
Marescaux  JDallemagne  BPerretta  SWattiez  AMutter  DCoumaros  D Surgery without scars: report of transluminal cholecystectomy in a human being.  Arch Surg 2007;142 (9) 823- 827PubMedGoogle Scholar
Kumar  MAgrawal  CSGupta  RK Three-port versus standard four-port laparoscopic cholecystectomy: a randomized controlled clinical trial in a community-based teaching hospital in eastern Nepal.  JSLS 2007;11 (3) 358- 362PubMedGoogle Scholar
Leung  KFLee  KWCheung  TYLeung  LCLau  KW Laparoscopic cholecystectomy: two-port technique.  Endoscopy 1996;28 (6) 505- 507PubMedGoogle Scholar
Kagaya  T Laparoscopic cholecystectomy via two ports, using the “Twin-Port” system.  J Hepatobiliary Pancreat Surg 2001;8 (1) 76- 80PubMedGoogle Scholar
Leggett  PLBissell  CDChurchman-Winn  R Cosmetic minilaparoscopic cholecystectomy.  Surg Endosc 2001;15 (10) 1229- 1231PubMedGoogle Scholar
Reddy  NRao  P Per oral transgastric endoscopic appendectomy in human.  Presented at: the 45th Annual Conference of the Society of Gastrointestinal Endoscopy of India February 28-29, 2004 Jaipur, India
Original Article
August 14, 2009

Single-Incision Laparoscopic Cholecystectomy Using a Flexible Endoscope

Author Affiliations

Author Affiliations: Department of Surgery, St Luke[[rsquo]]s-Roosevelt Hospital Center, New York, New York.

Arch Surg. 2009;144(8):734-738. doi:10.1001/archsurg.2009.129

Objective  To describe our experience with a single-incision laparoscopic cholecystectomy (SILC) performed using a flexible endoscope as the means of visualization and surgical dissection. The use of flexible endoscopy in intra-abdominal surgery has never been described.

Design  Prospective observational case series.

Patients  Eleven patients with symptomatic cholelithiasis were selected based on age, clinical presentation, body habitus, and history of previous abdominal surgery. Patients with acute or chronic cholecystitis were excluded.

Results  All procedures were completed laparoscopically via the single umbilical incision without the need to convert to an open operation and without introduction of any additional laparoscopic instruments or trocars. The mean operative time was 149.5 minutes (range, 99-240 minutes). The mean length of hospital stay was 0.36 days. There were no associated intraoperative or postoperative complications.

Conclusions  In our experience, SILC performed with a flexible endoscope is feasible and safe. Further studies are needed to determine its advantages in reference to postoperative pain and complication rate in juxtaposition with the current standard laparoscopic cholecystectomy.