Preferences help
enabled [disable] Abstract
Number of results
2015 | 86 | 4 | 177-180
Article title

Single-Incision Laparoscopic Cholecystectomy - can we Afford that? Cost Comparison of Different Surgical Techniques

Title variants
Languages of publication
One of the most commonly performed surgeries in general surgery wards with laparoscopic technique as a method of choice is gall-bladder excision. In addition to -the commonly used conventional laparoscopic cholecystectomy single incision laparoscopic cholecystectomy is getting more and more attention. Despite many works and studies comparing these methods, there is still a shortage of results assessing efficiency of this new surgical technique. The aim of the study was to evaluate cost-effectiveness of this method in Polish financial reality. We have analyzed costs of three different surgical techniques: conventional (multi- incision) laparoscopic cholecystectomy, SILC and ‘no -port’ SILC. Material and methods. We conducted a retrospective study that compared three groups of patients who underwent treatment with conventional laparoscopic cholecystectomy (n=20), SILC (n=20) and no-port SILC (n=20). These groups were matched by age, sex and BMI. Following parameters were analyzed: complication rate, operative time, operative costs, length of hospital stay, hospitalization costs. The SILC cases were performed with one of the three-trocar SILC ports available on the market. The ‘no- port’ SILC cases were performed by single skin incision in the umbilicus, insertion of one 10 mm trocar for the operating instrument, another instrument and scope were inserted directly thorough small incisions in the aponeurosis without a dedicated port Results. The average operative cost was significantly higher in the SILC group comparing to the conventional laparoscopy group and the no-port SILC group. There was no significant difference in complication rate, operative time, length of hospital stay, or hospitalization costs between the three groups Conclusions. Currently the cost of the dedicated SILC port does not allow a regular use of this procedure in Polish financial reality. According to our experience improved cosmesis is the only advantage of the single incision laparoscopy, therefore we believe that it is reasonable to consider this technique in a a very selected group of patients.
Physical description
1 - 4 - 2014
16 - 3 - 2014
27 - 6 - 2014
  • Department of General Surgery, Jagiellonian University Medical College in Cracow
  • Department of General Surgery, Jagiellonian University Medical College in Cracow
  • Department of General Surgery, Jagiellonian University Medical College in Cracow
  • Department of General Surgery, Jagiellonian University Medical College in Cracow
  • Department of General Surgery, Jagiellonian University Medical College in Cracow
  • Department of General Surgery, Jagiellonian University Medical College in Cracow
  • 1. Strzałka M, Matyja M, Matłok M et al.: Application of the single access technique in laparoscopic surgery. Pol Przegl Chir 2013 1; 85(2): 73-77.
  • 2. Rasić Z, Schwarz D, Nesek VA et al.: Single incision laparoscopic cholecystectomy - a new advantage of gallbladder surgery. Coll Antropol 2010; 34(2): 595-8.[PubMed]
  • 3. Budzyński A, Pędziwiatr M, Matłok M et al.: Preliminary experience with transperitoneal single incision laparoscopic surgery adrenalectomy. Wideochir Inne Tech Mało Inwazyjne 2010; 5 (3): 87-92.
  • 4. Feinberg EJ, O’Connor DJ, Feinberg ML et al.: Single-incision laparoscopic appendectomy: an early experience. Am Surg 2011; 77(3): 286-89.[PubMed]
  • 5. Jacob BP, Tong W, Reiner M et al.: Single incision total extraperitoneal (one SITE) laparoscopic inguinal hernia repair using a single access port device. Hernia 2009; 13: 571-72.[PubMed][Crossref][WoS]
  • 6. Barbaros U, Dinccag A: Single incision laparoscopic splenectomy: the first two cases. J Gastrointest Surg 2009; 13: 1520-23.[Crossref][PubMed]
  • 7. Varela JE: Single-site laparoscopic sleeve gastrectomy: preclinical use of a novel multi-access port device. Surgical Innovation 2009; 16: 207-10.[WoS][PubMed][Crossref]
  • 8. Merchant AM, Lin E: Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 2009; 52: 1021-24.[PubMed][Crossref]
  • 9. Froghi F, Sodergren MH, Darzi A, Paraskeva P: Single-incision Laparoscopic Surgery (SILS) in general surgery: a review of current practice. Surg Laparosc Endosc Percutan Tech 2010; 20(4): 191-204.[Crossref]
  • 10. Katsuno G, Fukunaga M, Nagakari K et al.: Single-incision laparoscopic colectomy for colon cancer: early experience with 31 cases. Dis Colon Rectum 2011; 54(6): 705-10.[Crossref][PubMed]
  • 11. Chow AG, Purkayastha S, Zacharakis E, Paraskeva P: Single-incision laparoscopic surgery for right hemicolectomy. Arch Surg 2011; 146(2): 183-86.[WoS][PubMed][Crossref]
  • 12. Huang CK: Single-incision laparoscopic bariatric surgery. J Minim Access Surg 2011; 7(1): 99-103.[PubMed]
  • 13. Kurpiewski W, Pesta W, Kowalczyk M, Głowacki L et al.: The outcomes of SILS cholecystectomy in comparison with classic four-trocar laparoscopic cholecystectomy. Wideochir Inne Tech Mało Inwazyjne 2012; 7(4): 286-93. doi: 10.5114/ wiitm.2011.30811. Epub 2012 Sep 29.[Crossref][PubMed]
  • 14. Laski D, Stefaniak TJ, Makarewicz W et al.: Single incision laparoscopic surgery - is it time for laboratory skills training? Wideochir Inne Tech Mało Inwazyjne 2013; 8(3): 216-20. doi: 10.5114/ wiitm.2011.33811. Epub 2013 Mar 12.[PubMed][WoS][Crossref]
  • 15. Budzyński A, Matłok M, Pędziwiatr M et al.: SILS (single incision laparoscopic surgery) - new surgical approach to peritoneal cavity. Adv Med Sci 2011; 56(1): 18-24. doi: 10.2478/v10039-011-0007-1.[WoS][PubMed][Crossref]
  • 16. Misiak A, Szczepanik AB: Laparoscopic cholecystectomy with single incision laparoscopic surgery. Pol Merkur Lek 2009; 27(161): 372-74.
  • 17. Kobiela J, Stefaniak T, Laski D et al.: NOTES. Study on patients’ perspective. Wideochir Inne Tech Mało Inwazyjne 2013; 8(3): 232-7. doi: 10.5114/ wiitm. 2011.34212. Epub 2013 Mar 26.[PubMed][Crossref]
  • 18. Seo IY, Lee JW, Rim JS: Laparoendoscopic single-site radical nephrectomy: a comparison with conventional laparoscopy. J Endourol 2011; 25(3): 465-69.[PubMed][Crossref]
  • 19. Ferrara V, Giannubilo W, Azizi B et al.: SILS extraperitoneal radical prostatectomy. Minerva Urol Nefrol 2010; 62(4): 363-69.
  • 20. Kim TJ, Lee YY, Kim MJ et al.: Single port access laparoscopic adnexal surgery. J Minim Invasive Gyn 2009; 16: 612-15.[PubMed]
  • 21. Langebrekke A, Qvigstad E: Total laparoscopic hysterectomy with single-port access without vaginal surgery. J Minim Invasive Gynecol 2009; 16: 609-11.
  • 22. Ponsky TA, Diluciano J, Chwals W et al.: Early experience with single-port laparoscopic surgery in children. J. Laparoendosc. Adv Surg Tech A 2009; 19: 551-53.
  • 23. Ergün O, Tiryaki S, Celik A: Single center experience in single-incision laparoscopic surgery in children in Turkey. J Pediatr Surg 2011; 46(4): 704-07.[Crossref][PubMed]
  • 24. Prasad A, Mukherjee KA, Kaul S Kaur M: Postoperative pain after cholecystectomy: Conventional laparoscopy versus single-incision laparoscopic surgery. J Minim Access Surg 2011; 7(1): 24-27.[PubMed]
  • 25. Ito M, Asano Y, Horiguchi A et al.: Cholecystectomy using single-incision laparoscopic surgery with a new SILS port. J Hepatobiliary Pancreat Sci 2010; 17(5): 688-91. [WoS]
Document Type
Publication order reference
YADDA identifier
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.