단일 지렛대 원리를 이용한 단일통로 복강경 담낭절제술 : 변형된 단일절개, 다투관침 방법

Abstract

Purpose: Several techniques and devices have recently been introduced for single-incision laparoscopic cholecystectomy. We describe our technique using standard laparoscopic instruments and ports, and report the initial results. Methods: Between March 2009 and June 2010, 60 consecutive patients underwent single-fulcrum laparoscopic cholecystectomy for benign gallbladder disease. The general patient characteristics and perioperative results, including the operation time, conversion rate and complications, were assessed retrospectively. Results: Seventeen (28.3%) patients were male and 43 (71.7%) patients were female. The mean age was 47.4±12.4 years, and the mean total operation time was 57.5±13.9 min. The operation time became stable after 30 cases. There was no conversion to conventional laparoscopic cholecystectomy or open surgery. Additional trocars were required in three patients due to intraoperative complications, which were managed successfully with additional trocars. The intraoperative complications included loosening of the clips on the cystic duct, vertical laceration of the cystic duct, and burn injuries to the duodenal wall. There was no postoperative morbidity. Conclusion: Despite the limited sample size in this series, the results suggest that single-fulcrum laparoscopic cholecystectomy is safe and feasible for the treatment of benign gallbladder disease. Nevertheless, a further prospective randomized controlled trial comparing this technique with conventional techniques will be needed to confirm its true clinical value.