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single-port versus multi-port cholecystectomy for patients with acute cholecystitis: a retrospective comparative analysis

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 521-525页

作者： Dietmar Jacob Roland Raakow Department of Surgery Center for Minimally Invasive Surgery Vivantes Hospital Spandau Neue Bergstrasse 6 13585 Berlin Germany Department of Surgery Vivantes Klinikum Am Urban Dieffenbachstrasse 1 10967 Berlin Germany

BACKGROUND: Trans-umbilical single-port laparoscopic cholecystectomy for chronic gallbladder disease is becoming increasingly accepted worldwide. But so far, no reports exist about the challenging single-port surgery for acute cholecystitis. The objective of this study was to describe our experience with single-port cholecystectomy in comparison to the conventional laparoscopic technique. METHODS: Between August 2008 and March 2010, 73 patients with symptomatic gallbladder disease and histopathological signs of acute cholecystitis underwent laparoscopic cholecystec- tomy at our institution. Thirty-six patients were operated on with the single-port technique (SP group) and the data were compared with a control group of 37 patients who were treated with the multi-port technique (MP group). RESULTS: The mean age in the SP group was 61.5 (range 21-81) years and in the MP group was 60 (range 21-94) (P=0.712). Gender, ASA status and BMI were not significantly different. The number of white blood cells was different before [SP: 9.2 (range 2.8-78.4); MP: 13.2 (range 4.4-28.6); P=0.001] and after the operation [SP: 7.8 (range 3.5-184.8); MP: 11.1 (range 5-20.8); P=0.002]. Mean operating time was 88 (range 34-174) minutes in the SP group vs 94 (range 39-209) minutes in the MP group (P=0.147). Four patients (5%) required conversion to an open procedure (SP: 1; MP: 3; P=0.320). During the follow- up period of 332 (range 29-570) days in the SP group and 428 (range 111-619) days in the MP group (P=0.044), eleven (15%) patients developed postoperative complications (P=0.745) and two patients in the SP group required reoperation (P=0.154). CONCLUSIONS: Trans-umbilical single-port cholecystectomy for beginning acute cholecystitis is feasible and the complicationrate is comparable with the standard multi-port operation. In spite of our good results, these operations are difficult to perform and should only be done in high-volume centers for laparoscopic surgery with experience in sin

关键词： laparoscopic surgery single-port cholecystectomy acute cholecystitis

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single-port laparoscopic surgery for sigmoid volvulus

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World Journal of Gastroenterology 2015年第8期21卷 2381-2386页

作者： Byung Jo Choi Won Jun Jeong Say-June Kim Sang Chul Lee Department of Surgery Daejeon St. Mary’s Hospital College of Medicine The Catholic University of Korea

AIM:To report our experience with single-port laparoscopic surgery(SPLS)for sigmoid volvulus(SV).METHODS:Between October 2009 and April 2013,10patients underwent SPLS for *** was performed transumbilically or through a predetermined stoma *** straight and rigid-type laparoscopic instruments were *** intracorporeal,segmental resection of the affected sigmoid colon,the specimen was extracted through the single-incision *** and perioperative data were ***:SPLS for SV was successful in all 10 patients(4,resection and primary anastomosis;6,Hartmann’s procedure).The median operative time and postoperative hospitalization period were 168(range,85-315)min and 6.5(range,4-29)d,*** intraoperative complications were noted;there were 2 postoperative complications,including 1 anastomotic ***:SPLS was a safe and feasible therapeutic approach for SV,when performed by a surgeon experienced in conventional laparoscopic surgery.

关键词： Sigmoid volvulus Laparoscopy single-port Anastomos

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A comparison of perioperative outcomes between extraperitoneal robotic single-port and multiport radical prostatectomy with the da Vinci Si Surgical System

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Asian Journal of Andrology 2021年第6期23卷 640-647页

作者： Guan-Qun Ju Zhi-Jun Wang Jia-Zi Shi Zong-Qin Zhang Zhen-Jie Wu Lei Yin Bing Liu Lin-Hui Wang Dong-Liang Xu Department of Urology Changzheng HospitalNaval Medical UniversityShanghai 200003China Urology Centre Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 200021China

To evaluate outcomes between extraperitoneal robotic single-port radical prostatectomy(epR-spRP)and extraperitoneal robotic multiport radical prostatectomy(epR-mpRP)performed with the da Vinci Si Surgical System,comparison was performed between 30 single-port(SP group)and 26 multiport(MP group)*** included operative time,estimated blood loss(EBL),hospital stay,peritoneal violation,pain scores,scar satisfaction,continence,and erectile *** median operation time and EBL were not different between the two *** the SP group,the median operation time of the first 10 patients was obviously longer than that of the latter 20 patients(Psingle-port robotic surgery platform,we can still provide minimally invasive surgery for patients.

关键词： extraperitoneal approach minimally invasive surgery prostate cancer robotic radical prostatectomy single-port

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Technical and instrumental prerequisites for single-port laparoscopic solo surgery:state of art

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World Journal of Gastroenterology 2015年第15期21卷 4440-4446页

作者： Say-June Kim Sang Chul Lee Department of Surgery Daejeon St. Mary’s Hospital College of Medicine The Catholic University of Korea Daejeon

With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery(SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed singleport solo surgery(SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanicaldevices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator's eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.

关键词： Camera holder Laparoscopy single-portlaparoscopic surgery single-port solo surgery Solosurgery

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First 100 cases of transvesical single-port robotic radical prostatectomy

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Asian Journal of Urology 2023年第4期10卷 416-422页

作者： Roxana Ramos-Carpinteyro Ethan L.Ferguson Jaya S.Chavali Albert Geskin Jihad Kaouk Glickman Urological&Kidney Institute Cleveland Clinic FoundationClevelandOHUSA

Objective:To describe the surgical technique and report the early outcomes of the transvesical(TV)approach to single-port(SP)robot-assisted radical ***:All procedures were performed at a single center by one *** identified the first 100 consecutive patients with clinically localized prostate cancer that underwent SP TV robot-assisted radical prostatectomy using the da Vinci SP robotic surgical *** were collected prospectively and analyzed with descriptive *** primary outcomes assessed were postoperative urinary continence,rate of biochemical recurrence,and sexual ***:All procedures were performed without extra ports or *** median age was 62.1 years and 49.0%of the patients had abdominal surgery *** preoperative median prostate-specific antigen value and prostate volume were 5.0 ng/mL and 33.0 mL,*** were no intraoperative *** median operative time and estimated blood loss were 212.5 min and 100.0 mL,respectively.A total of 92.0%of patients were discharged within 24.0 h,with an overall median length of stay of 5.6 *** 4.0%of patients required opioid prescriptions at *** median Foley catheter duration was 3 *** margins were present in 15.0%of *** follow-up was 10.4 *** rate was immediate after Foley removal in 49.0%of cases,65.0%at 2 weeks,77.4%at 6 weeks,94.1%at 6 months,and 98.9%at 1 *** case of biochemical recurrence(1.0%)was noted 3 months after ***:The SP TV approach for radical prostatectomy cases is a safe and feasible technique for patients with clinically localized prostate *** technique offers advantages of short hospital stay,minimal narcotic use postoperatively,and promising early return of urinary continence,without compromising oncologic outcomes.

关键词： Prostate cancer Radical prostatectomy Robotic-assisted surgery single-port Minimally-invasive surgery

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single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study

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Chinese Medical Journal 2020年第3期133卷 285-291页

作者： Yong-Li Zhang Guo-Cheng Wang Jun-Jie Qu Gui-Qiang Du Wei-Qiang Zhou Department of Obstetrics and Gynecology Shanghai First Maternity and Infant HospitalTongji University School of MedicineShanghai 201204China.

Background:The incidence of uterine cesarean scar defect(niche)is high,and some patients require ***-port laparoscopy can reduce post-operative pain,and provide better cosmetic *** study was performed to evaluate the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scar defect(niche)in women after cesarean ***:This study included 74 patients who were diagnosed with uterine cesarean niche at the Shanghai First Maternity and Infant Hospital from January 2013 to June ***-seven patients underwent single-port laparoscopy-assisted vaginal surgery as the case group,and the remaining patients underwent vaginal repair surgery as the control *** collected data from the inpatient and follow-up medical *** clinical characteristics of these two groups were *** odds ratios and 95%confidential intervals were calculated for each variable by univariate and multivariate ***:Patients who underwent single-port laparoscopy-assisted vaginal repair had a significantly longer operation time(2.3[2.0-2.7]vs.2.0[1.6-2.3]h,P=0.015),shorter gas passage time(1.2[1.0-1.5]vs.1.7[1.0-2.0]days,P=0.012),shorter hospital stay(3.1[3.0-4.0]vs.4.5[4.0-6.0]days,P=0.019),and fewer complications(0 vs.4 cases).Univariate analysis showed that depth of the niche(P=0.021)the mild adhesiolysis score(P=0.035)and moderate adhesiolysis score(P=0.013)were associated with the bladder *** analysis showed that the moderate adhesiolysis score(P=0.029;95%confidence interval,1.318-3.526)was the strongest independent predictor of bladder ***:This study confirmed the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scars.

关键词： single-port laparoscopy Uterine cesarean scar defect(niche) Adhesion

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single-port laparoscopic cholecystectomy vs standard laparoscopic cholecystectomy:A non-randomized,agematched single center trial

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World Journal of Gastrointestinal Surgery 2015年第8期7卷 145-151页

作者： Yoen TK van der Linden Koop Bosscha Hubert A Prins Daniel J Lips Department of Surgery Jeroen Bosch Hospital

AIM: To compare the safety of single-port laparoscopic cholecystectomies with standard four-port ***: Between January 2011 and December 2012 datas were gathered from 100 consecutive patients who received a single-port cholecystectomy. Patient baseline characteristics of all 100 single-port cholecystectomies were collected(body mass index, age, etc.) in a database. This group was compared with 100 age-matched patients who underwent a conventional laparoscopic cholecystectomy in the same period. Retrospectively, per- and postoperative data were added. The two groups were compared to each other using independent t-tests and χ2-tests, P values below 0.05 were considered significantly ***: No differences were found between both groups regarding baseline characteristics. Operating time was significantly shorter in the total single-port group(42 min vs 62 min, P single-port group vs 5 in the multiport group; P = 0.42). Although not significant less postoperative complications were seen in the single-port group compared with the multiport group(3 vs 9; P = 0.07). No statistically significant differences were found between both groupswith regard to length of hospital stay, readmissions and mortality. CONCLUSION: single-port laparoscopic cholecystectomy has the potential to be a safe technique with a low complication rate, short in-hospital stay and comparable operating time. single-port cholecystectomy provides the patient an almost non-visible scar while preserving optimal quality of surgery. Further prospective studies are needed to prove the safety of the single-port technique.

关键词： single-port Minimal invasive Laparoscopy Safety Fe

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single-port Bilateral Thoracscopic Dorsal Sympathectmy for Primary Hyperhidrosis:Long-Term Outcome

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World Journal of Cardiovascular Surgery 2014年第4期4卷 56-68页

作者： Aram Baram Salam Al Bermani Department of Thoracic and Cardiovascular Surgery Faculty of Medical SciencesSchool of MedicineUniversity of SulaimaniFrancois Mitterrand StreetSulaymaniyah46001Iraq Departement of Thoracic Surgery Sulaimani Directorate of HealthTeaching HospitalFrancois Mitterrand StreetSulaymaniyah46001Iraq

Background: Primary hyperhidrosis of the upper limbs is characterized by over activity of the eccrine sweat glands, primarily occurring on palmar, plantar and axillary regions. It is distressing and often socially disabling condition. Conservative treatment is usually not effective in controlling the disease mainly due to adverse effect of therapies. Endoscopic thoracic sympathectomy is considered as the treatment of choice, causing minimal morbidity and high success rates and patient satisfaction. Objective: The study aims to evaluate the long-term outcomes of single port bilateralthoracoscopic dorsal sympathectomyin treatment of primary hyperhidrosis of the palm and axilla. Methods: In this prospective study, performed primarily by a single surgeon, between August 1st 2010, and August 1st 2012, we performed 200 thoracoscopies on 100 patients with signs and symptoms of primary palmar and axillary hyperhidrosis in different age groups and in both genders, and all were studied and analyzed following treatment by single-port bilateral thoracoscopic dorsal sympathectomy in Sulaimani teaching hospital. Results: Total of 99 patients were satisfied with the outcome of post-surgery with a follow-up in the mean of 27 months and only one patient was reported no change in symptoms postoperatively. Complications reported in 6 patients inform of compensatory sweating (n = 2), Gestatory sweating (n = 1), Pneumothorax (n = 1), Intraoperative minor bleeding (n = 1) and only 1% failure rate was reported. No mortality was reported. Conclusions: single port bilateral thoracoscopic thoracic sympathectomy is a very effective method in the management of primary hyperhidrosis. single port provides less postoperative pain, safety, short operative time, and quick method for the treatment of primary hyperhidrosis in comparison to two or three ports approaches.

关键词： Primary Hyperhidrosis single-port Sympathectomy Long-Term Outcome

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Evaluation of the single-port Laparoscopic Right Hemicolectomy Learning Curve

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Surgical Science 2013年第10期4卷 433-437页

作者： Virgilio V. George Michael J. Guzman Joshua A. Waters Andrea L. Jester Don J. Selzer Bruce W. Robb Department of Surgery Indiana University School of Medicine Indianapolis USA

Background: The use of single-port laparoscopy has gained popularity within recent years. Part of the appeal in learning this approach is that it draws heavily from concepts mastered through conventional laparoscopy. Various studies have shown the efficacy and feasibility of the single-port laparoscopic approach, but there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better define the learning curve in performing a single-port laparoscopic right hemicolectomy. Design: A review of prospectively gathered operative data was performed to analyze the results of single-port laparoscopic right hemicolectomies performed within our institution by experienced laparoscopic surgeons. The first 100 cases were divided into quintiles. Comparisons were made among the cohorts regarding patient demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions, length of stay, and number of complications did not significantly vary among each group of patients. There was a significant difference in estimated blood loss and length of stay between the fifth cohort and the others due to one patient’s poor outcome. Conclusions: The single-port laparoscopic right hemicolectomy learning curve for surgeons already skilled in laparoscopy is short. There are few differences in various outcome measures among groups at any stage in the learning curve. The skills utilized to perform conventional laparoscopic colorectal surgery readily translate to the single-port approach and result in proficiency from nearly the start.

关键词： single-port Laparoscopy Learning Curve Colectomy

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New trends in colorectal surgery: single port and natural orifice techniques

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World Journal of Gastroenterology 2014年第48期20卷 18104-18120页

作者： Ronald Daher Elie Chouillard Yves Panis Department of General and Digestive Surgery Poissy/Saint-Germain Medical Center 78300Poissy France Department of Colorectal Surgery Beaujon Hospital Assistance Publique Hopitaux de Paris University Denis Diderot (Paris VII) 75013 Clichy France

single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) have rapidly gained pace worldwide, potentially replacing conventional laparoscopic surgery (CLS) as the preferred colorectal surgery technique. Currently available data mainly consist of retrospective series analyzed in four meta-analyses. Despite conflicting results and lack of an objective comparison, SILS appears to offer cosmetic advantages over CLS. However, due to conflicting results and marked heterogeneity, present data fail to show significant differences in terms of operative time, postoperative morbidity profiles, port-site complications rates, oncological appropriateness, duration of hospitalization or cost when comparing SILS with conventional laparoscopy for colorectal procedures. The application of “pure” NOTES in humans remains limited to case reports because of unresolved issues concerning the ideal access site, distant organ reach, spatial orientation and viscera closure. Alternatively, minilaparoscopy-assisted natural orifice surgery techniques are being developed. The transanal “down-to-up” total mesorectum excision has been derived for transanal endoscopic microsurgery (TEM) and represents the most encouraging NOTES-derived technique. Preliminary experiences demonstrate good oncological and functional short-term outcomes. Large-scale randomized controlled trials are now mandatory to confirm the long-term SILS results and validate transanal TEM for the application of NOTES in humans.

关键词： Surgery Colon Rectum Cancer Laparoscopy single-port Natural orifice transluminal endoscopic surgery

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