Four-channel single incision laparoscopic cholecystectomy using a snake retractor: comparison between 3- and 4-channel SILC 4-channel single incision cholecystectomy.
10.4174/astr.2014.87.2.81
- Author:
Nak Song SUNG
1
;
In Seok CHOI
;
Ju Ik MOON
;
Yu Mi RA
;
Sang Eok LEE
;
Won Jun CHOI
Author Information
1. Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea. choiins@kyuh.ac.kr
- Publication Type:Original Article
- Keywords:
Cholecystectomy;
Laparoscopy;
Single incision;
4-channel
- MeSH:
Arteries;
Bile;
Cholecystectomy*;
Cholecystectomy, Laparoscopic*;
Drainage;
Gallbladder;
Hemorrhage;
Humans;
Inflammation;
Laparoscopy;
Length of Stay;
Liver;
Snakes*;
Traction
- From:Annals of Surgical Treatment and Research
2014;87(2):81-86
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Single incision laparoscopic cholecystectomy (SILC) is a widely used method of performing cholecystectomy. A common technique used in SILC is a 3-channel method. However, exposure of Calot's triangle is limited in conventional 3-channel SILC. Therefore, we herein report the adequacy and feasibility of 4-channel SILC using a snake retractor. METHODS: Four hundred and fifteen SILC cases were performed between April 2010 and February 2013. We performed 326 SILC cases between April 2010 and September 2012 using the 3-channel method. We introduced a snake retractor for liver traction in October 2012, and 89 cases of 4-channel SILC using snake retractor have been performed since. RESULTS: Thirty patients (9.2%) in the 3-channel SILC group, and 23 patients (25.8%) in the 4-channel SILC group, were treated with percutaneous transhepatic gallbladder drainage insertion because of acute inflammation of the gallbladder (GB) before operation (P < 0.001). The mean operating time was 53.0 +/- 25.8 minutes in the 3-channel SILC group and 51.9 +/- 18.6 minutes in the 4-channel SILC group (P = 0.709). In the 3-channel SILC group, mean hospital stay was 3.0 +/- 3.3 days whereas it was 2.6 +/- 0.9 days in the 4-channel SILC group (P = 0.043). There were a total 9 cases (2.1%) of additional port usages, 6 cases (1.8%) in the 3-channel SILC group and 3 cases (3.4%) in the 4-channel SILC group (P = 0.411), due to cystic artery bleeding and bile leakage from gallbladder bed, but there were no open conversions. CONCLUSION: Benign diseases of the GB can be operated on using SILC with the 4-channel method using a snake retractor.
