Transumbilical Single-port Laparoscopic Cholecystectomy:a Report Of38Cases

[Background] Laparoscopic cholecystectomy is the standard surgery for resection of gallbadder currently, the traditional laparoscopic cholecystectomy needs3-4punctures in the abdominal cavity, but with the growing popularity of the concept of minimally invasive surgery, the traditional laparoscopic cholecystectomy can not meet the requirements of neither patients nor surgeons, and they are trying to find a less invasive and better cosmetic results of surgery. Transumbilical single-port laparoscopic cholecystectomy use the traditional laparoscopic instruments to complete the surgery with single or multiple working channal in the umbilical puncture. The umbilicus is the natural scar of bodies from embryonic stage, which can play the effect of masking the surgical scar and get a perfect cosmetic results, further more it has a lot of advantages in post-operative pain, shorter hospital stay and improvement in the postoperative quality of life. However, because of a higher standard for surgical instruments and surgical techniques, transumbilical single-port laparoscopic cholecystectomy has not been extensively disseminated in our country currently. Qianfoshan Hospital Affiliated to Shandong University has carried out this surgery since August2010, and until February2012they have got38cases, accumulated a certain amount of experience in the transumbilical single-port laparoscopic cholecystectomy surgery.[Objective] to study the safety and feasibility of transumbilical single-port laparoscopic cholecystectomy, the effect in cosmetic results and the improvement in quality of life. [Methods] The clinical data of38patients who went through a tansumbilical single-port laparoscopic cholecystectomy in Qianfoshan Hospital Affiliated to Shandong University from August2010to February2012were retrospectively analyzed. Including17cases of male,21cases of female, aged from23to46, mean age35.8,25cases of gallstone patients,13cases of gallbladder polyps in patients.38cases were performed successfully without conversion to conventional laparoscopic surgery or open surgery.[Results]38cases were performed successfully without conversion to conventional laparoscopic surgery or open surgery, the operation time was20-105min, and the average time is41.2min, less in blood loss, no drainage tube was placed. All pationts have a good postoperative recovery, no bleeding, bile leakage, wound infection, umbilical hernia and other complications, patients were discharged after2-4days. A follow-up in1month without symptoms, and observation of the umbilical scar is difficult to find.[Conclusion] At this stage, transumbilical single-port laparoscopic surgery is safe, feasible, and also have certain advantages in postoperative pain, cosmetic results and quality of life. Although it takes a longer time than traditional laparoscopic cholecystectomy, and has a higher demand in surgical techniques and surgical instruments, we believe that with the improvement of surgical skills and surgical instruments, transumbilical single-port laparoscopic cholecystectomy will get a full development and extensive application, make a wider space for the development of minimally invasive surgety.