Single-Incision Laparoscopic Cholecystectomy (SILC) Using Harmonic Scalpel

BackgroundSingle-incision laparoscopic cholecystectomy (SILC) is emerging as a potentially less invasive alternative to standard laparoscopic cholecystectomy (LC). However, this procedure is technically more complex and time consuming. We present our initial experience with SILC using harmonic ACE (HS-SILC) in an attempt to simplify the procedure.MethodsWe collected concurrent data on 67 consecutive patients undergoing HS-SILC by a single surgeon in a university-affiliated hospital over a period of 9 mo.ResultsFrom May 2010 to February 2011, 67 consecutive patients underwent an attempted HS-SILC for symptomatic cholelithiasis by a single surgeon, with a success rate of 95.5%. Conversion to a standard LC was necessary in two patients (2.9%), and conversion to an open cholecystectomy was necessary in one patient (1.6%). The average operative time was 36.2 min. No injuries to the common bile duct occurred. Postoperative port site infection occurred in one patient (1.5%). No perioperative deaths occurred.ConclusionsHS-SILC is safe and feasible. It simplifies the procedure and makes operative time less with better cosmetic results and lower rate of conversion to multi-incision LC or open cholecystectomy.