Single incision versus standard 4-port laparoscopic cholecystectomy: a prospective randomized trial.

Creator(s)

Daniel J. Ostlie
David Juang, Children's Mercy HospitalFollow
Corey W. Iqbal
Susan W. Sharp
Charles L. Snyder, Children's Mercy HospitalFollow
Walter S. Andrews, Children's Mercy HospitalFollow
Ronald J. Sharp
G W. Holcomb III, Children's Mercy HospitalFollow
Shawn D. St Peter, Children's Mercy HospitalFollow
Obinna O. Adibe

Document Type

Article

Publication Date

1-1-2013

Identifier

DOI: 10.1016/j.jpedsurg.2012.10.039

Abstract

BACKGROUND: Laparoscopy through a single umbilical incision is an emerging technique supported by case series, but prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing single site umbilical laparoscopic cholecystectomy to 4-port laparoscopic cholecystectomy.

METHODS: After IRB approval, patients were randomized to laparoscopic cholecystectomy via a single umbilical incision or standard 4-port access. The primary outcome variable was operative time. Utilizing a power of 0.8 and an alpha of 0.05, 30 patients were calculated for each arm. Patients with complicated disease or weight over 100 kg were excluded. Post-operative management was controlled. Surgeons subjectively scored degree of technical difficulty from 1=easy to 5=difficult.

RESULTS: From 8/2009 through 7/2011, 60 patients were enrolled. There were no differences in patient characteristics. Operative time and degree of difficulty were greater with the single site approach. There were more doses of analgesics used and greater hospital charges in the single site group that trended toward significance.

CONCLUSION: Single site laparoscopic cholecystectomy produces longer operative times with a greater degree of difficulty as assessed by the surgeon. There was a trend toward more doses of post-operative analgesics and greater hospital charges with the single site approach.

Journal Title

Journal of pediatric surgery

Volume

48

Issue

1

First Page

209

Last Page

214

MeSH Keywords

Adolescent; Child; Child, Preschool; Cholecystectomy, Laparoscopic; Female; Gallbladder Diseases; Humans; Infant; Infant, Newborn; Male; Operative Time; Pain, Postoperative; Prospective Studies; Treatment Outcome

Keywords

Gall Bladder Surgery

Comments

Secondary source ID

• ClinicalTrials.gov/NCT00981604

Recommended Citation

Ostlie, D. J., Juang, D., Iqbal, C. W., Sharp, S. W., Snyder, C. L., Andrews, W. S., Sharp, R. J., Holcomb, G. W., St Peter, S. D., Adibe, O. O. Single incision versus standard 4-port laparoscopic cholecystectomy: a prospective randomized trial. Journal of pediatric surgery 48, 209-214 (2013).