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Single-port-access (SPATM) cholecystectomy: a multi-institutional report of the first 297 cases |
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| Authors: | Paul G. Curcillo II Andrew S. Wu Erica R. Podolsky Casey Graybeal Namir Katkhouda Alex Saenz Robert Dunham Steven Fendley Marc Neff Chad Copper Marc Bessler Andrew A. Gumbs Michael Norton Antonio Iannelli Rodney Mason Ashkan Moazzez Larry Cohen Angela Mouhlas Alex Poor |
| Affiliation: | 1. Department of Surgery, Drexel University College of Medicine, 219 North Broad Street, Philadelphia, PA, 19107, USA 2. Northeast Georgia Surgical Associates, Gainesville, GA, USA 3. University of Southern California, Los Angeles, CA, USA 4. Department of Surgery, Clinica Sagrada Familia, Barcelona, Spain 5. Queen of the Valley Medical Center, Napa, CA, USA 6. Wiregrass Surgical Associates, Dothan, AL, USA 7. Surgical Care Associates, Cherry Hill, NJ, USA 8. Northeast Georgia Medical Center, Gainesville, GA, USA 9. Columbia University Medical Center, New York, NY, USA 10. Fox-Chase Cancer CenterDothan, Philadelphia, PA, USA 11. Trinity Mother Frances Clinic Surgery, Tyler, TX, USA 12. Chirurgien des Hopitaux, University of Nice-Sophia-Antipolis, Nice, France 13. Drexel University College of Medicine, Philadelphia, PA, USA |
| Abstract: | BackgroundAn important aspect of a new surgical technique is whether it can be performed by other surgeons in other institutions. The authors report the first 297 cases in a multi-institutional and multinational review of laparoscopic cholecystectomy performed via a single portal of entry.MethodsData were collected retrospectively for the initial patients undergoing single-port cholecystectomy by 13 surgeons who performed these procedures in their institutions after training by the authors. The review included operative time, blood loss, incision length, length of hospital stay (LOS), necessary additional trocars, and other parameters important to cholecystectomy. A database of all the single-port-access (SPA) surgeries performed by the surgeons included demographic and procedural details, LOS, complications, and initial follow-up data.ResultsTo date, 297 single-port cholecystectomies have been performed for a variety of diagnoses, primarily cholelithiasis. The average operative time was 71 min, and the average LOS was 1–2 days. The average blood loss was minimal. The use of additional port sites outside the umbilicus occurred in 34 of the cases. Of the 35 intraoperative cholangiograms performed, 34 were successful. No significant complications occurred except for seromas and minor postoperative wound infections. These results are comparable with those for standard multiport cholecystectomy. In addition, no access site hernias (ASH) occurred.ConclusionsThe findings demonstrate that SPA surgery is an alternative to multiport laparoscopy with fewer scars and better cosmesis. One factor affecting the rate for adoption of SPA surgery among other surgeons is the reproducibility of this new procedure. Although this study had insufficient data to determine fully the benefits of SPA surgery, the feasibility of this procedure with safe, acceptable results was demonstrated in this initial large series across multinational institutions. |
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