SS  Vol.4 No.12 , December 2013
Comparison of Double-Incision Laparoscopic Cholecystectomy and Needlescopic Cholecystectomy

Purpose: Recently, reduced port surgery is becoming popular for laparoscopic surgery. “Reduced” means reducing the size or number of ports, but it is controversial as to which procedure is better. We evaluated double-incision laparoscopic cholecystectomy (DILC) and needlescopic cholecystectomy (NC) as reducing number or size of ports, respectively. Method: Patient records for 51 patients undergoing DILC and 22 patients undergoing NC were retrospectively evaluated. The patient and operation related variables of DILC and NC were compared by age, gender, body mass index (BMI), operative time, blood loss, length of postoperative hospital stay, numerical rating scale (NRS) pain score, and frequency to administer NSAIDs postoperatively for three days. Results: The operative times of both groups were similar (DILC 106 ± 31 min, NC 103 ± 35 min). Blood loss did not show any difference and each of them was small in amount (DILC 14 ± 29 ml, NC 22 ± 31 ml). Length of postoperative hospital stay of DILC (3.2 ± 0.4 days) was significantly shorter than that of NC (3.5 ± 0.7 days). Regarding postoperative pain, frequency to administer NSAIDs and pain score for three days postoperatively showed no significant difference. Conclusion: It is thought that DILC and NC have the same operative difficulty. As far as early postoperative pain was concerned, both procedures did not have any difference.

Cite this paper
K. Ko, S. Yamada, K. Hayashi, A. Tsunoda, H. Kusanagi and N. Kano, "Comparison of Double-Incision Laparoscopic Cholecystectomy and Needlescopic Cholecystectomy," Surgical Science, Vol. 4 No. 12, 2013, pp. 530-534. doi: 10.4236/ss.2013.412103.

[1]   P. Bucher, F. Pugin, C. Buchs, S. Ostermann and P. Morel, “Randomized Clinical Trial of Laparoendoscopic Single-Site versus Conventional Laparoscopic Cholecystectomy,” British Journal of Surgery, Vol. 98, No. 12, 2011, pp. 1695-1702.

[2]   D. Mutter, C. Callari, M. Diana, B. Dallemagne, J. Leroy and J. Marescaux, “Single Port Laparoscopic Cholecystectomy: Which Technique, Which Surgeon, for Which Patient? A Study of the Implementation in a Teaching Hospital,” Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 18, No. 3, 2011, pp. 453-457.

[3]   M. A. Kia, C. Lee, J. M. Martinez and N. Zundel, “Single Port Cholecystectomy: The Pathway Back to a Standardized Technique,” Surgical Laparoscopy Endoscopy & Percutaneous Techniques, Vol. 21, No. 5, 2011, pp. 314-317.

[4]   P. L. Leggett, C. D. Bissell, R. Churchman-Winn and C. Ahn, “Three-Port Microlaparoscopic Cholecystectomy in 159 Patients,” Surgical Endoscopy, Vol. 15, No. 3, 2001, pp. 293-296.

[5]   M. Hirota, T. Takada, Y. Kawarada, Y. Nimura, F. Miura, K. Hirata, et al., “Diagnostic Criteria and Severity Assessment of Acute Cholecystitis: Tokyo Guidelines,” Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 14, No. 1, 2007, pp. 78-82.

[6]   G. Navarra, E. Pozza, S. Occhionorelli, P. Carcoforo and I. Donini, “One-Wound Laparoscopic Cholecystectomy,” British Journal of Surgery, Vol. 84, No. 5, 1997, p. 695. 1002/bjs.1800840536

[7]   S. R. Markar, A. Karthikesalingam, S. Thrumurthy, L. Muirhead, J. Kinross and P. Paraskeva, “Single-Incision Laparoscopic Surgery (SILS) vs. Conventional Multiport Cholecystectomy: Systematic Review and Meta-Analysis,” Surgical Endoscopy, Vol. 26. No. 5, 2012, pp. 1205-1213. 1007/s00464-011-2051-0

[8]   M. S. Phillips, J. M. Marks, K. Roberts, R. Tacchino, R. Onders, G. DeNoto, et al., “Intermediate Results of a Prospective Randomized Controlled Trial of Traditional Four-Port Laparoscopic Cholecystectomy versus Single-Incision Laparoscopic Cholecystectomy,” Surgical Endoscopy, Vol. 26, No. 5, 2012, pp. 1296-1303.

[9]   D. J. Ostlie, O. O. A. D. Juang, C. W. Iqbal, S. W. Sharp, C. L. Snyder, W. S. Andrews, et al., “Single Incision versus Standard 4-Port Laparoscopic Cholecystectomy: A Prospective Randomized Trial,” Journal of Pediatric Surgery, Vol. 48. No. 1, 2013, pp. 209-214. j.jpedsurg.2012.10.039

[10]   J. Ma, M. A. Cassera, G. O. Spaun, C. W. Hammill, P. D. Hansen and S. Aliabadi-Wahle, “Randomized Controlled Trial Comparing Single-Port Laparoscopic Cholecystectomy and Four-Port Laparoscopic Cholecystectomy,” Archives of Surgery, Vol. 254, No. 1, 2011, pp. 22-27. 1097/SLA.0b013e3182192f89

[11]   S. Trastulli, R. Cirocchi, J. Desiderio, S. Guarino, A. Santoro, A. Parisi, et al., “Systematic Review and Meta-Analysis of Randomized Clinical Trials Comparing Single-Incision versus Conventional Laparoscopic Cholecystectomy,” British Journal of Surgery, Vol. 100, No. 2, 2013, pp. 191-208.

[12]   S. H. Ju, D. G. Lee, J. H. Lee, M. K. Baek, B. C. Jeong, S. S. Jeon, et al., “Laparoendoscopic Single-Site Pyeloplasty Using Additional 2 mm Instruments: A Comparison with Conventional Laparoscopic Pyeloplasty,” Korean Journal of Urology, Vol. 52, No. 9, 2011, pp. 616-621. 10.4111/kju.2011.52.9.616

[13]   C. H. Hsieh, “Early Minilaparoscopic Cholecystectomy in Patients with Acute Cholecystitis,” The American Journal of Surgery, Vol. 185, No. 4, 2003, pp. 344-348.

[14]   M. T. Huang, W. Wang, P. L. Wei, R. J. Chen and W. J. Lee, “Minilaparoscopic and Laparoscopic Cholecystectomy: A Comparative Study,” Archives of Surgery, Vol. 138, No. 9, 2003, pp. 1017-1023.

[15]   P. H. Cabral, I. T. Silva, J. V. Melo, F. S. Gimenez, C. R. Cabral and A. P. Lima, “Needlescopic versus Laparoscopic Cholecystectomy. A Prospective Study of 60 Patients,” Acta Cirurgica Brasileira, Vol. 23, No. 6, 2008, pp. 543-550.

[16]   Y. W. Novitsky, K. W. Kercher, D. R. Czerniach, G. K. Kaban, S. Khera, K. A. Gallagher-Dorval, et al., “Advantages of Mini-Laparoscopic vs. Conventional Laparoscopic Cholecystectomy: Results of a Prospective Randomized Trial,” Archives of Surgery, Vol. 140, No. 12, 2005, pp. 1178-1183.

[17]   M. S. Sajid, M. A. Khan, K. Ray, E. Cheek and M. K. Baig, “Needlescopic versus Laparoscopic Cholecystectomy: A Meta-Analysis,” ANZ Journal of Surgery, Vol. 79, No. 6, 2009, pp. 437-442.

[18]   R. McCloy, D. Randall, S. A. Schug, H. Kehlet, C. Simanski, F. Bonnet, et al., “Is Smaller Necessarily Better? A Systematic Review Comparing the Effects of Minilaparoscopic and Conventional Laparoscopic Cholecystectomy on Patient Outcomes,” Surgical Endoscopy, Vol. 22, No. 12, 2008, pp. 2541-2553.

[19]   N. Tagaya, A. Abe and K. Kubota, “Needlescopic Surgery for Liver, Gallbladder and Spleen Disease,” Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 18, No. 4, 2001, pp. 516-524.

[20]   M. Gagner and A. Garcia-Ruiz, “Technical Aspects of Minimally Invasive Abdominal Surgery Performed with Needlescopic Instruments,” Surgical Laparoscopy Endoscopy, Vol. 8, No. 3, 1998, pp. 171-179.