Single-incision versus four-port laparoscopic cholecystectomy in an ambulatory surgery setting: A prospective randomised double-blind controlled trial
Helena Subirana1, Francisco Javier Rey2, Joan Barri2, Joaquim Robres2, Lourdes Parra3, Montserrat Martín4, Robert Memba5, Josep Maria Mullerat1, Rosa Jorba5
1 Department of General Surgery, Hospital Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain
2 Department of General Surgery, Hospital General de l'Hospitalet, Consorci Sanitari Integral, Barcelona, Spain
3 Department of Anesthesiology, Hospital General de l'Hospitalet, Consorci Sanitari Integral, Barcelona, Spain
4 Department of Clinical Epidemiology, Hospital General de l'Hospitalet, Consorci Sanitari Integral, Barcelona, Spain
5 Department of General Surgery, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain
Jacint Verdaguer 90, 08970 Sant Joan Despí, Barcelona
Source of Support: None, Conflict of Interest: None
Background: Single-incision laparoscopic cholecystectomy (SILC) can be done as a day-case procedure and may have advantages over conventional laparoscopic cholecystectomy (LC). We present the results of our study looking at post-operative pain and post-operative recovery time.
Methods: This was a single-institution randomised double-blind controlled trial. Seventy-three patients with symptomatic cholelithiasis were randomized to SILC (n = 37) or LC (n = 36). The primary endpoint was to compare post-operative pain. We also compared surgical time, procedural difficulty, adverse events, additional ports used and conversion rate, success of day surgery process, return to work, aesthetic satisfaction, quality of life and 4-year incisional hernia rate.
Results: In the SILC group, post-operative analgesic requirements were lower on day 7, there was an earlier return to work and cosmetic satisfaction was significantly higher. The SILC procedure presented a higher technical difficulty. Operative time, surgical complications, post-operative pain, success of the day-case process, return to normal activity, quality of life scores and incisional hernia rates were similar for both the procedures.
Conclusions: SILC has advantages over LC in terms of late post-operative analgesic requirements and aesthetic results; however, it is technically harder to perform. There was no benefit in terms of day surgery outcomes.