Transumbilical single-port laparoscopic cholecystectomy

  Since the first laparoscopic cholecystectomy was performed in 1991, after years of development, laparoscopic cholecystectomy has undergone the four-port method, three-port method, two-port method, and finally the breakthrough of single-port, and the indications for laparoscopic cholecystectomy have been expanded.  Transumbilical single-port laparoscopic cholecystectomy (TSLC) utilizes the umbilical recess to hide the incision, which can achieve excellent cosmetic results. Compared with traditional laparoscopic cholecystectomy, there is no significant difference in operation time, operation effect, average hospital stay and complication rate, which is worth promoting.  Since 2011, our department has carried out “three-instrument method single-port laparoscopic cholecystectomy”, which uses disposable rubber gloves to inflate the umbilicus and place the laparoscopic head and two operating instruments respectively, with multiple instruments entering the abdominal cavity through a narrow orifice, and the linear field of view, coaxial instruments and light source, and the limitation of traditional rigid instruments make the operating space and field of view The linear field of view, the coaxiality of instruments and light source, and the limitation of traditional rigid instruments make the surgical space and field of view very narrow, which makes the operation more difficult and limits the promotion of the operation. On this basis, our department has successfully performed a modified single-port laparoscopic resection after several explorations and learning from the experience of other hospitals.  This “three-point method” single-port laparoscopic cholecystectomy is more economical and practical, completely using conventional laparoscopic operating instruments, avoiding expensive special single-port instruments; moreover, it is simple to operate, using a hanging wire to subtly alleviate the difficulties of multi-instrument operation through a single port; safety is guaranteed, and complicated or difficult cases can be converted to conventional LC or open surgery; patients have fewer postoperative complications, faster recovery, and other characteristics. Because of the natural depression of the navel and the concealing effect, single-port laparoscopic cholecystectomy is performed using transumbilical poke holes. As a modified technique, single-port laparoscopic cholecystectomy through the umbilicus has obvious advantages such as less trauma and significant cosmetic effect, which is worth promoting. The successful implementation of this case marked the move of our laparoscopic technology from multi-hole to single-hole era, and the surgery is more minimally invasive and safe.