Skip to main content
SpringerLink
Log in

Comparison between single-incision and conventional laparoscopic cholecystectomy: a prospective trial of the Club Coelio

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to compare the outcomes of single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC).

Method

Patients’ inclusion criteria were uncomplicated gallstones, BMI ≤30, ASA score ≤2, and no past surgery in the upper abdomen. Five surgeons performed only SILC and seven only CLC. Data analyzed included operative time, morbidity, quality of life (QOL), cosmetic result, and global patient satisfaction. The last three parameters were evaluated 3 months after surgery. QOL was assessed with the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. Cosmetic result and patient satisfaction were rated using a 5-grade Likert scale.

Results

This study included 104 patients operated on between April and June 2010. A SILC was performed in 35 patients and a CLC in 69. The preoperative characteristics of the two groups were similar. Median operative time for SILC was higher than that for CLC: 55 versus 40 min (p < 0.001). Postoperative complications (0 vs. 2) and postoperative GIQLI scores (123 ± 13 vs. 121 ± 18) were not significantly different between groups. Cosmetic result and patient satisfaction were better for SILC than for CLC. The percentages of results rated as excellent were 68 versus 37 % (p < 0.006) and 80 versus 57 % (p < 0.039), respectively. For the whole group, multivariate statistical analysis revealed that postoperative GIQLI score and cosmetic result were independent predictive factors of patient satisfaction. The percentages of satisfaction rated as excellent were greater in patients who had a postoperative GIQLI score ≥130 (92 vs. 49 %, odds ratio [OR] = 4, p < 0.001) and in patients who had an excellent cosmetic result (82 vs. 47 %, OR = 7, p < 0.001).

Conclusions

Compared to CLC, SILC is associated with a longer operative time, an equivalent morbidity and QOL, and a better cosmetic result. The improved aesthetic result also leads to a better global patient satisfaction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chamberlain R, Sakpal S (2009) A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 9:1733–1740

    Article  Google Scholar 

  2. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  3. Bokobza B, Valverde A, Magne E et al (2010) Single umbilical incision laparoscopic cholecystectomy: the early experience of the Club Coelio. J Visc Surg 147:253–257

    Article  Google Scholar 

  4. Edwards C, Bradshaw A, Ahearne P et al (2010) Single-incision laparoscpic cholecystectomy is feasible: initial experience with 80 patients. Surg Endosc 24:2241–2247

    Article  PubMed  Google Scholar 

  5. Hernandez J, Morton C, Ross S, Albrink M, Rosemurgy A (2009) Laparoendoscopic single site cholecystectomy: the first 100 patients. Am Surg 75:681–685

    PubMed  Google Scholar 

  6. Rivas H, Varela E, Scott D (2010) Single-incision laparoscopic cholecystectomy: initial evaluation of a large series of patients. Surg Endosc 24:1403–1412

    Article  PubMed  Google Scholar 

  7. Erbella J, Bunch G (2010) Single-incision laparoscopic cholecystectomy: the first 100 outpatients. Surg Endosc 24:1958–1961

    Article  PubMed  Google Scholar 

  8. Curcillo P, Wu A, Podolsky E et al (2010) Cholecystectomy: a multi-institutional report of the first 297 cases. Surg Endosc 24:1854–1860

    Article  PubMed  Google Scholar 

  9. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  Google Scholar 

  10. Slim K, Bousquet J, Kwiatkowski F, Lescure G, Pezet D, Chipponi J (1999) First validation of the French version of the gastrointestinal quality of life index (GIQLI). Gastroenterol Clin Biol 23:25–31

    PubMed  CAS  Google Scholar 

  11. Eypasch E, Willians J, Wood-Daphinee S et al (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg 82:216–222

    Article  PubMed  CAS  Google Scholar 

  12. National Institutes of Health (1993) Consensus conference: gallstones and laparoscopic cholecystectomy. JAMA 269:1018–1024

    Article  Google Scholar 

  13. Keus F, Gooszen HG, van Laarhoven C (2010) Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. an overview of Cochrane hepato-biliary group reviews. Cochrane Database Syst Rev (1):CD008318

  14. Connor S (2009) Single-port-access cholecystectomy: history should not be allowed to repeat. World J Surg 33:1020–1021

    Article  PubMed  Google Scholar 

  15. Tsimoyiannis E, Tsimogiannis K, Pappas-Gogos G et al (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: A randomized controlled trial. Surg Endosc 24:1842–1848

    Article  PubMed  Google Scholar 

  16. Fronza J, Linn J, Nagle A, Soper N (2010) A single institution’s experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy. Surgery 148:731–734

    Article  PubMed  Google Scholar 

  17. Lee P, Lo C, Lai P, Chang J, Huang S, Lin M, Lee P (2010) Randomised clinical trial of single-incision laparoscopic cholecystectomy versus minlaparoscopic cholecystectomy. Br J Surg 97:1007–1012

    Article  PubMed  Google Scholar 

  18. Aprea G, Coppola E, Guida F, Masone S, Persico G (2011) Laparoendoscopic single site (LESS) versus classic video-laparoscopic cholecystectomy: a randomized prospective study. J Surg Res 166:109–112

    Article  Google Scholar 

  19. Asakuma M, Hayashi M, Komeda K et al (2011) Impact of single-port cholecystectomy on post-operative pain. Br J Surg 98:991–995

    Article  PubMed  CAS  Google Scholar 

  20. Marks J, Tacchino R, Roberts K et al (2011) Prospective randomised controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: Report of preliminary data. Am J Surg 201:369–373

    Article  PubMed  Google Scholar 

  21. Prasad A, Mukherjee K, Kaul S, Kaur M (2011) Postoperative pain after cholecystectomy: conventional laparoscopy versus single incision laparoscopic surgery. J Minim Access Surg 7:24–27

    PubMed  CAS  Google Scholar 

  22. Wu S, Han J, Tian Y (2011) Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a retrospective comparative study. J Laparoendosc Adv Surg Tech 21:25–28

    Article  Google Scholar 

  23. Ma J, Cassera M, Spaun G, Hammil C, Hansen P, Aliabadi-Whale S (2011) Randomised controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg 254:22–27

    Article  PubMed  Google Scholar 

  24. Lirici MM, Califano AD, Angelini P, Corcione F (2011) Laparoendoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial. Am J Surg 202:45–52

    Article  PubMed  Google Scholar 

  25. Lai EC, Yang GP, Tang CN, Yih PC, Chan OC, Li MK (2011) Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. Am J Surg 202:254–258

    Article  PubMed  Google Scholar 

  26. Joseph B, Todd Moore B, Brent Sorensen G et al (2011) Single-incision laparoscopic cholecystectomy: a comparison with the gold standard. Surg Endosc 25:3008–3015

    Article  PubMed  Google Scholar 

  27. Chow A, Purkayastha S, Omer A, Pefanis D, Paraskevas P (2011) Single-incision laparoscopic surgery. A retrospective comparison with 4-port laparoscopic cholecystectomy. Arch Surg 145:1187–1191

    Article  Google Scholar 

  28. Vidal O, Valentini M, Ginesta C et al (2011) Single-incision versus standard laparoscopic cholecystectomy: comparison of surgical outcomes from a single institution. J Laparoendosc Adv Surg Tech A 21:683–686

    Article  PubMed  Google Scholar 

  29. Joseph S, Philips M, Farrel T, Rupp C (2012) Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg 256:1–6

    Article  PubMed  Google Scholar 

  30. Waage A, Nilsson M (2006) Iatrogenic bile duct injury: a population-based study of 152,776 cholecystectomies in the Swedish inpatient registry. Arch Surg 141:1207–1213

    Article  PubMed  Google Scholar 

  31. Nuzzo G, Giuliante F, Giovannini I et al (2005) Bile duct injury during laparoscopic cholecystectomy: results of an Italian national survey on 56,591 cholecystectomies. Arch Surg 140:986–992

    Article  PubMed  Google Scholar 

  32. Markar S, Karthikesalingam A, Thurmurthy S, Muirhead L, Kinross J, Paraskeva P (2012) Single-incision laparoscopic (SILS) vs. conventional multiport cholecystectomy: systematic review and meta-analysis. Surg Endosc 26:1205–1213

    Article  PubMed  CAS  Google Scholar 

  33. Buemi A, Swaelens C, Gherardi D, Malvaux P, Landenne J, Hauters P (2012) Comparison between single incision and conventional laparoscopic cholecystectomy for uncomplicated cholelithiasis. Acta Chir Belg Suppl 112(3):33

    Google Scholar 

  34. Hauters P, Sorrentino J, Papillon M et al (2000) Assessment of quality of life after antireflux surgery. Ann Chir 125:948–953

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

Drs. Hauters, Auvray, Cardin, Papillon, Delaby, Dabrowski, Framery, Valverde, Rubay, Siriser, Malvaux, and Landenne have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. CH wapi site Notre-Dame, 9 Avenue Delmée, 7500, Tournai, Belgium

    Philippe Hauters, Philippe Malvaux & Jacques Landenne

  2. CHP Saint-Martin, 18 Rue des Roquemonts, 14050, Caen, France

    Sylvain Auvray & Frank Siriser

  3. Polyclinique du Maine, 4 Avenue des Français Libres, 5310, Laval, France

    Jean Luc Cardin

  4. Clinique Charcot, 53 Rue du Commandant Charcot, 69110, Sainte Foy Les Lyon, France

    Marc Papillon

  5. Clinique de l’Anjou, 87 Rue Château d’ Orgemont, 49000, Angers, France

    Jean Delaby

  6. Clinique Saint-Omer, 71 Rue Amboise Paré, 62575, Blendecques, France

    André Dabrowski

  7. CMC de la baie de Morlay, La Vierge Noire, 29600, Morlaix, France

    Dominique Framery

  8. Groupe Hospitalier Diaconesses Croix Saint-Simon, 125 Rue d’Avron, 75020, Paris, France

    Alain Valverde

  9. Clinique Saint-Jean, 32 Boulevard du Jardin Botanique, 1000, Bruxelles, Belgium

    Raphaël Rubay

Authors
  1. Philippe Hauters
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sylvain Auvray
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean Luc Cardin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marc Papillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jean Delaby
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. André Dabrowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dominique Framery
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alain Valverde
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Raphaël Rubay
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Frank Siriser
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Philippe Malvaux
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jacques Landenne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philippe Hauters.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hauters, P., Auvray, S., Cardin, J.L. et al. Comparison between single-incision and conventional laparoscopic cholecystectomy: a prospective trial of the Club Coelio. Surg Endosc 27, 1689–1694 (2013). https://doi.org/10.1007/s00464-012-2657-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-012-2657-x

Keywords

Search

Navigation