One-port Vs Three-port Laparoscopic Cholecystectomy

Aim: Laparoscopic cholecystectomy (LC) is the gold-standard for the treatment of benign disease of the gallbladder. In recent years laparoendoscopic single site surgery (LESS) has gained greater interest among the general sugeons. However, no randomized controlled trials are present in the literature that confirm the clinical advantages of LESS compared with the classic laparoscopic procedures. For this reason, we present the preliminary results of this randomized prospective study regarding the feasibility and safety of LESS cholecystectomy versus classic laparoscopic technique. To evaluate the safety and feasibility of transumbilical single-incision laparoscopic cholecystectomy.Methods:From September 2009 to April 2010,96 patients were randomly assigned to three-port classic laparoscopic cholecystectomy groups(n=48) or LESS groups (n=48). All the patients'basic details were recorded:gender, age, body mass index, ASA grade and indication of operation. Their operative time, estimated blood loss during operation, abdominal postoperative pain at 6h,12h,24h,36h after operation, usage of analgesic, complication during and after operation, functional rehabilitation time of gastrointestinal tract, postoperative hospitalized time and wound satisfaction score were constrasted.Results:No differences were registered between the two groups about gender, age, BMI, ASA grade, indications of operation, estimated blood loss during operation, complications during and after operation. operative time was significantly longer in LESS procedures, operative time of the previous 32 patients was longer than the latter 16 patients in LESS group. Abdominal postoperative pain was significantly lighter in LESS cholecystectomy at 6h,12h,24h after operation, compare to three-port classic laparoscopic cholecystectomy groups, usage of analgesic was less in LESS groups.As to hospital stay, LESS groups was significantly shorter than three-port classic laparoscopic cholecystectomy groups. Wound satisfaction score showed statistically significant differences between the two groups:in LESS group, patients were more satisfied with the presence of a small scar.Conclusions:Laparoendoscopic single site surgery (LESS) cholecystectomy is safe and feasible for patients with uncomplicated gallbladder disease, It has the advantages of mini invasion,light postoperative pain, rapid recovery, shorter hospital stay,more beautiful than conventional laparoscopic cholecystectomy,and is an excellent alternative to traditional three-port cholecystectomy in some cases.