Comparison of Single-Incision Laparoscopic Cholecystectomy versus Needlescopic Cholecystectomy: A Single Institutional Randomized Clinical Trial.
BACKGROUND
Both single-incision laparoscopic cholecystectomy (SILC) and needlescopic cholecystectomy (NSC) are superior to conventional laparoscopic cholecystectomy in terms of cosmetic outcome and incisional pain. We conducted a prospective, randomized clinical trial to evaluate the surgical outcome, postoperative pain, and cosmetic outcome for SILC and NSC procedures.


METHODS
In this trial, 105 patients were enrolled (52 in the SILC group; 53 in the NSC group). A visual analogue scale (VAS) was used to evaluate the cosmetic outcome and incisional pain for patients. Logistic regression analyses were used to evaluate the operative difficulty that was present for both procedures.


RESULTS
There were no significant differences in patient characteristics or surgical outcomes, including operative time and blood loss. The mean VAS scores for cosmetic satisfaction were similar in both groups. There were significant differences in the mean VAS scores for incisional pain on postoperative day 1 (p = 0.009), and analgesics were required within 12 h of surgery (p = 0.007). Obesity (body mass index ≥25 kg/m2) was the only significant influential factor for operating time over 100 min (p = 0.031).


CONCLUSION
NSC is superior to SILC in terms of short-term incisional pain. Experienced laparoscopic surgeons can perform both SILC and NSC without an increase in operative time.
['Umemura|Akira|A|', 'Suto|Takayuki|T|', 'Nakamura|Seika|S|', 'Fujiwara|Hisataka|H|', 'Endo|Fumitaka|F|', 'Nitta|Hiroyuki|H|', 'Takahara|Takeshi|T|', 'Sasaki|Akira|A|']
D000368:Aged D000700:Analgesics D002763:Cholecystectomy D017081:Cholecystectomy, Laparoscopic D005260:Female D042882:Gallstones D006801:Humans D008297:Male D008875:Middle Aged D009765:Obesity D061646:Operative Time D010149:Pain, Postoperative D017060:Patient Satisfaction D011446:Prospective Studies D016896:Treatment Outcome D064232:Visual Analog Scale
Single-incision laparoscopic cholecystectomy Laparoscopic cholecystectomy Needlescopic cholecystectomy Randomized clinical trial