Loop retraction of the gallbladder in single incision laparoscopic cholecystectomy*
BACKGROUND: Single incision laparoscopic surgery (SILS) is a modified laparoscopic technique with only one access through the umbilicus to avoid visible scars. One crucial step of a cholecystectomy is a good insight to the triangle of Calot. We present our technique to retract the gallbladder with a PDS-Endoloop fixed to the fundus and which is passed through the abdominal wall with the Endo CloseTM Trocar Site Closure Device. METHODS: Prospective study. RESULTS: Cholecystectomy was performed in 29 patients with the SILS-technique between 7/2009 and 3/2010. Twenty-four patients were female (82.8%), the median age was 50 years (range, 17–74) and the median body mass index was 25.9 kg/m2 (range, 20.5–34.0). Cholecystitis was present in 13 out of 29 patients (6 acute, 7 chronic), all others (55.2%) had no inflammatory signs. In the majority of the cases (69.0%) the PDS-Endoloop technique was feasible; in 4 cases there was no need for additional retraction with the PDS-Endoloop. In 5 cases the application of the PDS-Endoloop was not possible due to advanced inflammation of the gallbladder. No complications occurred. CONCLUSIONS: This technique is simple, safe and feasible and can be carried out in selected cases of cholecystitis. The main advantage is the prevention of bile leakage.