Khashayar Vaziri, MD; Alex P. Nagle, MD; Eric S. Hungness, MD
The laparoscopic approach has been widely accepted and applied to multiple different intra-abdominal procedures. This approach has been beneficial to patients by reducing the potential for wound related complications such as wound infection, future hernia formation, decreased pain, and faster recovery. Surgeons have strived to minimize the amount of surgical trauma by performing more procedures laparoscopically and reducing or eliminating the number of ports needed to perform a specific procedure, while maintaining the integrity and safety of the operation. This initiative has led to single port access surgery, where operations are performed through a single multi-instrument port, and natural orifice translumenal endoscopic surgery (NOTES) where all abdominal ports are eliminated.
This video illustrates a single port laparoscopic cholecystectomy with intra-operative cholangiogram. The cholecystectomy and cholangiogram is performed through a single infra-umbilical incision. A 5 mm 30 degree laparoscope was used for visualization and a variety of articulating and non-articulating instruments were used for dissection. The intra-operative cholangiogram was performed through the single incision with an Olsen Clamp.
Single port cholecystectomy with intraoperative cholangiogram is feasible and can be perfromed safely.
Single port cholecystectomy with cholangiogram can be performed without compromising patient safety or procedural integrity. Intra-operative cholangiogram is feasible and should be performed when indicated. Patient selection is important, particularly early in the surgical experience. Patient safety and procedural integrity should never be compromised.