Single-incision laparoscopic cholecystectomy: does it work? A systematic review

  title={Single-incision laparoscopic cholecystectomy: does it work? A systematic review},
  author={Marco Maria Lirici and Simone Maria Tierno and Cecilia Ponzano},
  journal={Surgical Endoscopy},
BackgroundSingle-incision laparoscopic cholecystectomy (SILC) has been widely introduced into the clinical practice, but the real clinical benefits for patients still remain a matter of debate. We conducted a systematic review, according to the PRISMA guidelines comparing clinical and peri-operative outcomes of SILC and conventional laparoscopic cholecystectomy (CLC).MethodA literature search, including only randomised controlled trials (RCTs), was performed via PubMed, Google Scholar, Cochrane… 

Single-Incision Laparoscopic Cholecystectomy: a Single-Centre Experience of 1469 Cases

It was showed that SILC can be performed safely without any increase in complications, as reported previously, and may be a useful technique due to its superior cosmetic outcomes or pain reduction.

Laparoscopic surgery and robotic surgery for single-incision cholecystectomy: an updated systematic review

Compared with conventional laparoscopic cholecystectomy, SIRC has experienced more postoperative incisional hernias than SILC, and the feasibility and safety of performing SILC and SIRC will improve.

Comparison of Single-Incision Laparoscopic Cholecystectomy versus Needlescopic Cholecystectomy: A Single Institutional Randomized Clinical Trial

A prospective, randomized clinical trial to evaluate the surgical outcome, postoperative pain, and cosmetic outcome for SILC and NSC procedures, finding that NSC is superior to SILC in terms of short-term incisional pain.

Laparoscopic Single-Port Versus Traditional Multi-Port Laparoscopic Cholecystectomy

SPLC has shown relevant procedure and postoperative outcomes when compared to traditional 4PLC and has proved to be promising even in cases of acute cholecystitis considered to date a relative contraindication.

Stabilization of Single-incision Laparoscopic Cholecystectomy by Needle Puncture and Bendable Retractor

Compared with conventional SILC, needlescopic grasper-assisted and bendable retractor-assisted SILC might become a mainstream procedure for minimally invasive surgery from the viewpoint of surgical difficulty.

Optimal indication of single-incision laparoscopic cholecystectomy using Konyang Standard Method in benign gallbladder diseases

SILC is not recommended in patients with grade II/III AC and should be carefully performed by experienced and well-trained surgeons.

Patient preference matters: cholecystectomy for uncomplicated gallbladder diseases should be performed by single port laparoscopy

SPA is a valid alternative to CLA for UGD and should be chosen when available, since it provides equal clinical outcomes, diminishes postoperative pain and is preferred by patients.

Comparative Risk of Surgical Site Infection With Open Cholecystectomy Vs Laparoscopic Cholecystectomy

It is concluded that the frequency of surgical site infection was found less in laparoscopic cholecystectomy than in open choleCystectomy.

A Comparative Study of Needlescopic Grasper Assisted Single Incision versus Three-Port versus Pure Single Incision Laparoscopic Cholecystectomy

Purpose Single incision laparoscopic cholecystectomy (SILC) is a surgical method to treat gallbladder disease designed to reduce postoperative pain and improve cosmetic results. However, pure SILC



Single-incision laparoscopic cholecystectomy: a comparison with the gold standard

Initial results indicate that single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC.

Single-incision Versus Conventional Laparoscopic Cholecystectomy in Patients With Uncomplicated Gallbladder Disease: A Meta-analysis

The current evidence shows that patients with uncomplicated cholelithiasis or polypoid lesions of the gallbladder who prefer a better cosmetic outcome, SILC offers a safe alternative to CLC.

Single-Incision Laparoscopic Cholecystectomy vs. Conventional Laparoscopic Cholecystectomy: a Meta-analysis of Randomized Controlled Trials

Single-incision laparoscopic cholecystectomy does not confer any benefit in postoperative pain (6 and 24 h) and hospital stay as compared to conventional laparoscope choleCystectomy while having significantly better cosmetic results at the same time.

Single-access Laparoscopic Cholecystectomy Versus Classic Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

SALC required longer operative times than CLC without significant benefits in patient overall satisfaction, postoperative pain, and hospital stay, and only satisfaction with the cosmetic result showed a significantly higher preference towards SALC.

Single-incision laparoscopic cholecystectomy: a cost comparison

The cost for SILC did not differ significantly from that for LC when standard materials were used and the duration of the procedure was considered, but converted cases were significantly more expensive than completed SILC and LC cases.

Single-incision Laparoscopic Cholecystectomy Versus Laparoscopic Cholecystectomy: A Prospective Randomized Study

Although the surgeon’s first several attempts at SILC require a longer operative time compared with LC, there are no differences in hospital length of stay, blood loss, complication rates, or pain scores between SILC and LC.

Expanding the Indications for Single-incision Laparoscopic Cholecystectomy to All Patients With Biliary Disease: Is it Safe?

It is concluded that SILC can be safely offered to patients with a wide spectrum of biliary disease with the understanding that this may result in increased operative times and a higher likelihood of conversion to multiport laparoscopy.

A Randomized Controlled Trial Comparing Post-operative Pain in Single-Incision Laparoscopic Cholecystectomy Versus Conventional Laparoscopic Cholecystectomy

This randomized trial compares SILC against four-port laparoscopic cholecystectomy with post-operative pain as the primary endpoint and concludes that SILC has improved short-term pain outcomes compared to LC and is not inferior in both short- term and long- term pain outcomes.

Randomized Controlled Trial Comparing Single-Port Laparoscopic Cholecystectomy and Four-Port Laparoscopic Cholecystectomy

SPLC procedure time was longer and incurred more complications than CLC without significant benefits in patient satisfaction, postoperative pain and QOL, but SPLC may be offered in carefully selected patients.