gms | German Medical Science

Introduction: Single-port access cholecystectomy (SPA) is an emerging concept in the field of minimally invasive surgery. In cholecystectomy, one of the gold standards for safety is preservation of the critical view of safety during hepatocystic triangle dissection. As single-port technique is more widely used it should not compromise this important operative principles of cholecystectomy. We report our experience in using a newly developed totally reusable multichannel port system for single-port cholecystectomy.

Materials and methods: Between August 2009 and August 2010, 59 patients with an average age of 45,3 years (range 19-84) underwent laparoscopic single port cholecystectomy for symptomatic cholelithiasis and acute cholecystitis using the totally reusable X-Cone^TM multichannel single-port device in all cases.

Results: Of the 59 laparoscopic cholecystectomies, 52 were performed successfully with the totally reusable port device alone using one single incision in the umbilicus. In seven cases additional 3mm or 5mm instruments were placed into the right upper abdominal wall. No mortalities or major complications were noted. The exposure of the Calot triangle could be achieved very well by a defined placing of holding-instruments through the five working-channel single port device. The median operating time was 80 min and the median postoperative hospital stay was 1.5 days.

Conclusion: The results of this sery demonstrated the feasibility of single port cholecystectomy with the used totally reusable system. The operating times are reasonable and can be lessened with experience. The clear exposition of Calot`s triangle is the mainstay of this method and was achieved by allowing enough controlled strength for retraction and sufficient triangulation for adequate exposure of the surgical field. Beside cost-effectiveness was convincing.