Solo single incision laparoscopic cholecystectomy using the parallel method; Surgical technique reducing a steep learning curve

• Published in: Annals of hepato-biliary-pancreatic surgery Vol. 23; no. 4; pp. 344 - 352
• Main Authors: Lee, Boram, Suh, Suk-Won, Choi, YoungRok, Han, Ho-Seong, Yoon, Yoo-Seok, Cho, Jai Young, Kim, Kil Hwan, Hyun, In Gun, Han, Sun Jong
• Format: Journal Article
• Language: English
• Published: Korea (South) 한국간담췌외과학회 01.11.2019; Korean Association of Hepato-Biliary-Pancreatic Surgery
• Subjects: Original; Cholecystectomy; Laparoscopy; Minimally invasive surgical procedures; Learning curve
• ISSN: 2508-5778; 2508-5859
• DOI: 10.14701/ahbps.2019.23.4.344

To describe the techniques, short-term outcomes, and learning curve of solo single-incision laparoscopic cholecystectomy (Solo-SILC) using a laparoscopic scope holder. A total of 591 patients who underwent Solo-SILC from July 2014 to December 2016 performed by four experienced hepatobiliary surgeons were retrospectively assessed. Solo-SILC was performed using the parallel method using a scope holder. The moving average method was used to investigate the learning curve in terms of operative time. In total, 590 Solo-SILC procedures were performed. Very few procedures were converted to multi-port laparoscopic cholecystectomy. There was one case of bile duct injury. The mean operative time (59.93±25.77 min) was shorter than that in other studies of SILC. Three postoperative complications, delaying bile leakage, occurred in the patients treated by one surgeon. These cases were resolved by ultrasound-guided puncture and drainage. The learning curve for surgeons A, B, and C was overcome after 14, 12, and 12 cases. Surgeon D, who had the most experience with SILC, had no obvious learning curve. Hepatobiliary surgeons experienced in LC can perform Solo-SILC almost immediately. Solo-SILC using the parallel technique represents a more stable option and is a promising treatment for gallbladder disease.