Laparoscopic Transumbilical Cholecystectomy: Surgical Technique

Introduction: Laparoscopy is a constantly evolving field of surgery. New technology, applications, and benefits prompt continual improvement, We have developed a Single Port Access (SPA) surgical technique that allows for the entire cholecystectomy to be performed through a single incision within the umbilicus while maintaining safe standard dissection and retraction techniques of currently performed multiport laparoscopic cholecystectomy. Methods: Fifteen consecutive partients underwent SPA cholesytectomy. Indications were cholelithiasis, cholecystistic, \ CBD stones, and biliary akinesia. The entire procedure was performed through a single umbilical incision measuring <1.8 cm within the umbilicus. Three trocars and a rigid grasper were inserted through separate fascial sites within the same skin incision. The cholecystectomy procedures are then performed in the standard fashion described in multi-port cholecystectomy. Results: Fifteen patient successfully underwent Single Port Access cholecystectomy. One patient required a second 5-mm port site secondary to difficulty with retraction of a large liver. Operative times averaged 107 minutes. Blood loss, patient recovery, and outcomes have been comparatble to those of standard multi-port procedures. No umbilical hernias have been seen at 2 years of follow-up. Conclusion: We present the SPA cholecstectomy as an alternative to mutli-port cholestectomy. In the first 2 years, SPA surgery has evolved into a technique easily taught and performed without the restrictions of new equipment or added cost.