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Stabilization of Single-incision Laparoscopic Cholecystectomy by Needle Puncture and Bendable Retractor

Takahashi, Kodai MD*; Kanehira, Eiji PhD*; Kamei, Aya MD*; Tanida, Takashi MD*; Sasaki, Kazunori MD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: December 2018 - Volume 28 - Issue 6 - p 375–379
doi: 10.1097/SLE.0000000000000539
Original Articles
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Background: A recent meta-analysis and systematic review suggested that single-incision laparoscopic cholecystectomy (SILC) had a higher procedure failure rate with more blood loss and that it required a longer surgical time than conventional laparoscopic cholecystectomy. Herein, we introduce our experience with the needlescopic grasper-assisted and bendable retractor-assisted SILC technique and evaluate its safety and sustainability.

Methods: The present retrospective cohort study included 407 Japanese patients who underwent needlescopic grasper-assisted and bendable retractor-assisted SILC between January 2012 and April 2017 at our institution.

Results: In the present study, all patients successfully underwent needlescopic grasper-assisted and bendable retractor-assisted SILC without conversion to open surgery. Regarding surgical outcomes, mean surgical time was 58.2±23.2 minutes, and additional ports were required in 9 patients (2.2%). Postoperative morbidity developed in only 6 patients (1.4%).

Conclusions: The surgical approaches defined herein were safe and sustainable with favorable surgical outcomes. Compared with conventional SILC, needlescopic grasper-assisted and bendable retractor-assisted SILC might become a mainstream procedure for minimally invasive surgery from the viewpoint of surgical difficulty.

*Department of Surgery, Medical Topia Soka, Saitama

Department of Surgery, Yokohama Shin Midori General Hospital, Kanagawa, Japan

The authors declare no conflicts of interest.

Reprints: Kodai Takahashi, MD, Department of Surgery, Medical Topia Soka, 1-11-18 Yatsuka Soka City, Saitama 340-0028, Japan (e-mail: kodaiyy@hotmail.co.jp).

Received October 26, 2017

Accepted April 17, 2018

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