Single-Port Laparoscopic Cholecystectomy Assisted with Neodymium Magnets: Initial Prospective Experience with 60 Cases.
Laparoscopic cholecystectomy (LC) is the gold standard performed by the majority of surgeons worldwide, and the use of single-port cholecystectomy remains a matter of debate. Single-port magnetic-assisted cholecystectomy (SPMAC) was described as an alternative because of its ability for proper triangulation and the advantage of reducing port surgery. The objective of this study is to describe the initial experience of SPMAC and evaluate the surgical learning curve.  A prospective cohort was conducted between February 2017 and August 2018; 60 patients completed the inclusion criteria. Variables analyzed were gender, age, body mass index, American Society of Anesthesiologist (ASA) classification, operative time, hospital stay, intraoperative bleeding, and conversion rate. Postoperative pain was measured with a visual analogue scale (VAS). Aesthetic perception was measured by the cosmetic visual analogue scale (CVAS). The postoperative complications were graded according to Clavien-Dindo classification, and the cumulative sum (CUSUM) model was used for evaluating the learning curve.  The mean operatory time was 56.1 minutes. With regard to the postoperative pain variable, the VAS value was 2 out of 10 in 78.33% of patients. With regard to aesthetic satisfaction, CVAS was reported to be 10 out of 10 in 96.67% of patients. Conversion rate was 0%. The learning curve of operative time was reached at the 22nd patient, according to the CUSUM chart.  SPMAC is feasible and effective; in our consideration, an acceptable learning curve considering benign gallbladder pathology is one of the most prevalent in general surgery. Further comparative studies with conventional LC and SPMAC need to be performed to conduct a proper comparison.
['Trujillo Loli|Yeray|Y|', 'Rodríguez-Luna|María Rita|MR|', 'Noriega-Usi|Víctor Manuel|VM|', "Trejo Huamán|Mario D'Carlo|MD|", 'Domínguez|Guillermo Manuel|GM|', 'Targarona Soler|Eduardo María|EM|']
D000328:Adult D017081:Cholecystectomy, Laparoscopic D005260:Female D006801:Humans D059032:Learning Curve D007902:Length of Stay D059346:Magnets D008297:Male D009354:Neodymium D061646:Operative Time D010147:Pain Measurement D010149:Pain, Postoperative D017060:Patient Satisfaction D011446:Prospective Studies
laparoscopic cholecystectomy neodymium magnets learning curve single port