SILS cholecystectomy – our first experiences

Introduction: Persistent urge to minimize operative trauma and improve the cosmetic effect after surgical treatment in recent years has contributed to the introduction of new minimally invasive techniques such as NOTES and SILS.
Aim: To present our first experience with SILS cholecystectomy performed via single access through the navel.
Material and methods: From February to June 2009, twenty-five SILS cholecystectomies were carried out using three 5 mm trocars inserted into the peritoneal cavity through a 2.5 cm-transverse incision in the umbilicus. Regular laparoscopic instruments were used.
Results: The average time of operation was 74.2 min. In one case, conversion to classic 4 trocar laparoscopy was necessary, for pressure could not be maintained due to dilation of trocars. In one patient an additional trocar was introduced in the right epigastrium due to difficulty in preparation of Calot’s triangle. Laparotomy was necessary in one case for biliary peritonitis as a consequence of Luschka duct overlooked during open surgery.
Conclusions: In our experience SILS cholecystectomy is a procedure that can be safely performed with existing laparoscopic instruments. The main benefit of this technique is a very good cosmetic effect, as the scar after the procedure is hardly visible.