ARE SINGLE-PORT ENDOSCOPIC TECHNOLOGIES A REAL ALTERNATIVE TO «TRADITIONAL» LAPAROSCOPIC PROCEDURES?
https://doi.org/10.17238/issn2072-3180.2020.3.12-16
Abstract
Introduction. Laparoscopic cholecystectomy is the «gold standard» of the treatment for patients with benign gallbladder diseases. In recent years, there has been a trend towards a decrease in the number of incisions for surgical intervention to single-port technologies.
Material and methods. In our study the results of single-port laparoscopic cholecystectomy at 300 patients were compared with standard laparoscopic cholecystectomy at 1150 patients.
Results. The duration of the laparoscopic cholecystectomy was 40 (35—60) minutes, the duration of the SILS was 55 (45—65) minutes. The conversion of SILS for «traditional» 4-puncture laparoscopic intervention was noted in 2.3% of patients, for open cholecystectomy in 0.3%, after LCE conversion of laparoscopic access to laparotomy was performed in 0.7% patients. Morbidity after laparoscopic cholecystectomy was 0.8%. Morbidity after SILS was 1%. Mortality after laparoscopic cholecystectomy was 0.17% (as a result of massive pulmonary embolism). Mortality after SILS was not. Pain syndrome after laparoscopic cholecystectomy was 6 (4—7) points, after SILS — 4 (3—5) points (p <0.05). Satisfaction of the results of treatment after laparoscopic cholecystectomy was 95%, after SILS — 98% (p <0.05). Duration of the postoperative hospital-stay after laparoscopic cholecystectomy was 3 (2—5) days, after SILS — 1 (1—2) days (p<0.05).
Conclusion. It was shown that SILS for various forms of cholelithiasis allows achieving optimal cosmetic results, moderate postoperative pain syndrome, rapid postoperative rehabilitation of patients, as well as an increase in overall satisfaction with treatment in patients compared with standard laparoscopic cholecystectomy. In addition, when performing SILS, it is possible to switch to traditional LCE in case of technical difficulties during the operation.
About the Authors
S. E. Voskanyan
«State Research Center Burnazyan FMBC of the FMBA of Russia»
Russian Federation
Russian Federation
Voskanyan Sergey Eduardovich — Corresponding member of the Russian Academy of Sciences, Doct. of Med., The Chief of the Surgical Service, Head of the Center for Surgery and Transplantology, Head of the Department of Surgery with courses of Oncosurgery, Endoscopy,
Surgical Pathology, Clinical Transplantology and Organ Donation of the Institute of Postgraduate Professional Education
123098, Moscow, Marshal Novikov str., 23
M. G. Lashchik
«State Research Center Burnazyan FMBC of the FMBA of Russia»
Russian Federation
Russian Federation
Lashchik Maxim Germanovich — PhD in Med., Surgeon, Head of the Operating Unit of the Center for Surgery and Transplantology, State Scientific Center Burnazyan FMBC of the FMBA of Russia
123098, Moscow, Marshal Novikov str., 23
E. V. Naidenov
«State Research Center Burnazyan FMBC of the FMBA of Russia»
Russian Federation
Russian Federation
Naidenov Evgenii Vladimirovich — PhD in Med., Surgeon of the Surgical department №2, Senior Researcher of the Laboratory of New surgical technologies №50, Center for Surgery and Transplantology, State Scientific Center Burnazyan FMBC of the FMBA of Russia
123098, Moscow, Marshal Novikov str., 23, Phone: +7-499-190-95-61
Yu. A. Bazhanova
«State Research Center Burnazyan FMBC of the FMBA of Russia»
Russian Federation
Russian Federation
Bazhanova Yulia Alexandrovna — Surgeon of the Surgical department №1, State Scientific Center Burnazyan FMBC of the FMBA of Russia
123098, Moscow, Marshal Novikov str., 23
References
1. Kurbanov F. S., Abbasova S. F., Alyaev Yu. G., Sushko A. N., Dobrovolsky S. R. Holecistektomiya iz laparoskopicheskogo dostupa u bol’nyh starshego vozrasta [Cholecystectomy from laparoscopic access in older patients]. Surgery, 2012. No. 9. pp. 38–41. (In Russ.)
2. Dadvani S.A., Vetshev P.S., Shulutko A.M., Prudkov M.I. ZHelchnokamennaya bolezn’ [Cholelithiasis]. М.: Vidar, 2000, 144 p. (In Russ.)
3. Pisanu A., Reccia I., Porceddu G., Uccheddu A. Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC). J. Gastrointest. Surg, 2012, 16(9), pp. 1790–1801.
4. Yahin R.R., Slavin L.E. 8-letnij opyt primeneniya odnoportovoj holecistektomii [8 years of experience with single-port cholecystectomy]. Practical medicine, 2017. Vol. 6. No. 107. pp. 66–68. (In Russ.)
5. Podolsky E.R., Curcillo P.G. 2nd. Single port access (SPA) surgery — a 24-month experience. J. Gastrointest. Surg., 201, 14(5), pp. 759–767.
6. Mozharovskii V.V., Misharin V.M., Tsyganov A.A., Mozharovskii K.V. Odnoportovaya holecistektomiya — za i protiv [Singleport cholecystectomy - pros and cons]. Surgery, 2016. No. 8. pp. 50–54. (In Russ.)
7. Lashchik M.G., Voskanyan S.E., Naidenov E.V. Pervyj opyt primeneniya odnoprokol’nyh endoskopicheskih tekhnologij na primere laparoskopicheskoj holecistektomii [The first experience for the application of single-incision endoscopic technologies on the example of laparoscopic cholecystectomy]. Doctor. Ru, 2015. No. S1. pp. 7–8. (In Russ.)
8. Ovechkin A.M., Bayalieva A.Zh., Ezhevskaya A.A., Eremenko A.A., Zabolotskii D.V., Zabolotskih I.B., Karelov A.E., Koryachkin V.A., Spasova A.P., Horonenko V.E., Uvarov D.N., Ulrih G.E., Shadrin R.V. Posleoperacionnoe obezbolivanie. Klinicheskie rekomendacii [Postoperative pain relief. Clinical guidelines]. Intensive care bulletin A.I. Saltanov, 2019. No. 4. pp. 9–33. (In Russ.)
Review
For citations:
Voskanyan S.E., Lashchik M.G., Naidenov E.V., Bazhanova Yu.A. ARE SINGLE-PORT ENDOSCOPIC TECHNOLOGIES A REAL ALTERNATIVE TO «TRADITIONAL» LAPAROSCOPIC PROCEDURES? Moscow Surgical Journal. 2020;(3):12-16. (In Russ.) https://doi.org/10.17238/issn2072-3180.2020.3.12-16
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