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Single‐port endoscopic cholecystectomy: a bridge between laparoscopic and translumenal endoscopic surgery
Author(s) -
Abe Nobutsugu,
Takeuchi Hirohisa,
Ueki Hisayo,
Yanagida Osamu,
Masaki Tadahiko,
Mori Toshiyuki,
Sugiyama Masanori,
Atomi Yutaka
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-009-0108-4
Subject(s) - cholecystectomy , medicine , endoscope , endoscopic surgery , gallbladder , abdominal surgery , surgery , retractor , port (circuit theory) , cystic duct , endoscopy , electrical engineering , engineering
Background and objective The intentional puncture of the normal viscera is likely the most important issue limiting the widespread use of natural orifice translumenal endoscopic surgery (NOTES). We developed a new procedure for cholecystectomy using a flexible endoscope via a single port placed in the abdominal wall without visceral puncture (single‐port endoscopic cholecystectomy; SPEC) as a bridge between laparoscopic surgery and NOTES. This study aimed to evaluate the technical feasibility of SPEC. Methods Five pigs were subjected to SPEC. An endoscope was inserted through a 12‐mm port placed in the right upper abdomen. After grasping and retracting the gallbladder using a 2‐mm retractor that was directly introduced into the peritoneal cavity, gallbladder excision with ligation of the cystic artery and duct using endoclips was carried out. Results A complete gallbladder excision was carried out easily and safely in all cases. No major adverse events occurred. The mean operating time was 67 min (range 52–84 min). Conclusions SPEC is a technically feasible procedure. It is simpler, easier, and safer than NOTES cholecystectomy. SPEC could be a less invasive alternative to the conventional four‐port laparoscopic cholecystectomy.