Single Umbilical Incision Laparoscopic Cholecystectomy

Aim: To assess the outcomes of single umbilical incision laparoscopic cholecystectomies (SILC) compared to conventional laparoscopic cholecystectomies (CLC).Patients and methods: We present a review of studies conducted by members of the Club Cœlio. As it is a review, the number of patients included in each arm cannot be specified for it varies for each considered items regarding the reference study.Results: SILC is usually proposed to selected patients with uncomplicated cholelithiasis and BMI < 35. Compared to 0° scope, the use of a 30° scope reduced the operative time from 76 to 56 minutes and conversion rate from 20 to 3%. Median operative time was higher for SILC than for CLC (55 vs. 40 min). Morbidity, postoperative pain, hospital stay and quality of life were similar for the two techniques. Aesthetic result, evaluated by visual analogue scale or 5-grade Likert scale, was better after SILC (73 vs. 28% of excellent results). The improved cosmetic result after SILC was correlated to a better overall satisfaction rate (80 vs. 57% of excellent results) and was still present one year after surgery (91 vs. 54% of excellent results). With a median follow-up of 40 months, the rate of umbilical incisional hernia was 8%, increased if BMI was over 28 (25%) and age over 50 (15%).Conclusion: In selected patients SILC is a safe technique associated with better aesthetic result. However, due to the potential higher risk of incisional hernia, SILC should be limited to young and non-obese patients.