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Solo single incision laparoscopic cholecystectomy using the parallel method; Surgical technique reducing a steep learning curve
Ann Hepatobiliary Pancreat Surg 2019 Nov;23(4):344-52
Published online November 30, 2019;  https://doi.org/10.14701/ahbps.2019.23.4.344
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Boram Lee1, Suk-Won Suh2, YoungRok Choi1, Ho-Seong Han1, Yoo-Seok Yoon1, Jai Young Cho1, Kil Hwan Kim1, In Gun Hyun1, and Sun Jong Han1

Department of Surgery, 1Seoul National University, College of Medicine, Seoul National University Bundang Hospital, Seongnam, 2Chung-Ang University, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
Received May 30, 2019; Revised July 14, 2019; Accepted July 25, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: To describe the techniques, short-term outcomes, and learning curve of solo single-incision laparoscopic cholecystectomy (Solo-SILC) using a laparoscopic scope holder.
Methods: 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.
Results: 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.
Conclusions: 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.
Keywords : Cholecystectomy; Laparoscopy; Minimally invasive surgical procedures; Learning curve

 

November 2019, 23 (4)