Department of Surgery, Manatee Memorial Hospital, 206 Second Street East, Bradenton, FL 34208, USA.
Surg Endosc. 2010 Aug;24(8):1958-61. doi: 10.1007/s00464-010-0886-4. Epub 2010 Jan 29.
Single-incision laparoscopic surgery (SILS) is a well-described technique for many general surgical procedures. The SILS techniques applied to cholecystectomy vary, and reporting has been sparse. Because most cholecystectomies are outpatient procedures performed by busy, practicing general surgeons, the authors report their initial experience adopting this technique.
From March, 2008 to January, 2009, SILS was performed for 100 consecutive outpatients needing cholecystectomy. All the patients underwent a single-incision, multiport laparoscopic (SIMPL) technique using existing instrumentation. The patients were followed postoperatively for at least 6 months.
Of the 100 patients, 98 underwent SIMPL cholecystectomy and 2 required conversion to the standard laparoscopic technique because of bleeding from the cystic artery. No major postoperative complications occurred, including infections and hernias.
The findings show SIMPL cholecystectomy to be safe in the outpatient setting. It is an excellent alternative to traditional three- or four-port cholecystectomy for the ideal candidate with a lower body mass index (BMI), early disease, and no previous abdominal surgery. The authors' initial outpatient experience shows that it can be performed using existing instrumentation without increasing costs by a reproducible technique that can be adopted by any practicing general surgeon.
单切口腹腔镜手术（SILS）是许多普通外科手术的一种成熟技术。应用于胆囊切除术的 SILS 技术有所不同，且相关报道较少。由于大多数胆囊切除术都是由忙碌的普通外科医生为门诊病人施行的，因此作者报告了他们最初采用这种技术的经验。
从 2008 年 3 月至 2009 年 1 月，对 100 例需要行胆囊切除术的连续门诊病人施行 SILS。所有病人均采用单切口多通道腹腔镜（SIMPL）技术，使用现有器械。对所有病人至少随访 6 个月。
在 100 例病人中，98 例行 SIMPL 胆囊切除术，2 例因胆囊动脉出血而需要转为标准腹腔镜技术。无重大术后并发症，包括感染和疝。
这些发现表明，SIMPL 胆囊切除术在门诊环境下是安全的。对于身体质量指数（BMI）较低、疾病早期且无既往腹部手术史的理想病人，它是传统三或四通道胆囊切除术的一种极好的替代方法。作者的初步门诊经验表明，它可以使用现有的器械、通过一种任何普通外科医生都能采用的可重复技术施行，而不会增加成本。
