Single-incision laparoscopic cholecystectomy: lessons learned for success

Since its introduclion approximately 20 years ago, laparoscopic cholecystectomy has rapidly become the treatment of choice Tor symptomatic cholelithiasis [1—3]. Conventional laparoscopic cholecystectomy generally is performed through four small incisions in the abdominal wall [4]. Fn recent years, a less invasive method has been sought in an effort to reduce postoperative pain and morbidities such as wound infection and trocar-site hernias while further enhancing the cosmetic results. Initial attempts to perform the procedure through three and then two ports or with reduced-diameter trocars (needlescopic surgery) [5-9J have since been superseded by even less invasive and more innovative techniques, namely, single-incision laparoscopic surgery (S1LS) and natural orifice transluminal endoscopic surgery (NOTES) [10-13].

Single-incision laparoscopic surgery is an attractive technique for cholecystectomy due to its superior cosmetic results and potential to reduce the rale of wound complications such as infection, hematoma, and hernia. This technique, however, is not straightforward. The technical complexity of SILS naturally results in a steep learning curve and increased operating room time and requires specialized equipment