ABSTRACT
BACKGROUND: As surgeons embrace the concept of increasingly less invasive surgery, techniques using only a single small incision have begun to gain traction. Multiple case series managed by a single-incision laparoscopic cholecystectomy (SILC) have been published. The objective of this study is to describe the short-term outcomes of SILC in our institution. METHODS: A retrospective review was done for 51 patients who underwent SILC between 2009-2012. The operative time, surgical technique, conversion rate, and postoperative complications were reported. RESULTS: SILC was performed for 51 patients, all women, with a mean age of 35.6 years (range=19-62). Their body mass index(BMI) ranged from 16.8-35.6 kg m2 with a mean of 20.4. Twelve patients (23.52 %) had acute cholecystitis. The mean operating time was 58.6 minutes (range=45-95 min). Incidents were encountered in 6 patients (11.76%) and were related to intraoperative bleeding. There was a single conversion to the standard laparoscopic procedure (1.9%) and in 5 cases an accessory needle grasp was used (9.8%). Two patients (3.9%)presented postoperative complications (wound infections) and the mean hospital stay was 1.6 days. CONCLUSIONS: SILC is feasible and provides a promising alternative to natural orifice transluminal endoscopic surgery for scarless laparoscopic cholecystectomy. However, routine application of this novel technique requires an evaluation of its safety and cost effectiveness in larger studies.
Subject(s)
Cholecystectomy, Laparoscopic/methods , Gallbladder Diseases/surgery , Length of Stay , Adult , Body Mass Index , Cholecystectomy, Laparoscopic/instrumentation , Cholecystitis, Acute/surgery , Cholecystolithiasis/surgery , Conversion to Open Surgery , Feasibility Studies , Female , Humans , Middle Aged , Operative Time , Retrospective Studies , Risk Assessment , Risk Factors , Treatment OutcomeABSTRACT
Meckel's diverticulum is a congenital disorder that results from an incomplete obliteration of the vitelline duct. Meckel's diverticulum may give rise to bleeding, intestinal obstruction and inflammation; however, its perforation by a foreign body is an extremely rare life-threatening complication. We report ona 37-year-old male presenting symptoms and signs of acute abdomen with an initial suspicion of acute appendicitis.However, the right diagnosis was made only during exploratory laparoscopy when the appendix was found to be normal,whereas Meckel's diverticulum was found to be inflamed and perforated by a chicken bone. The patient was treated successfully with laparoscopic resection of the diverticulum, and had an uncomplicated postoperative course.
